NPIMap

Organization Active NPI

Mark J Jensen OD PS

  • Optometrist
  • Issaquah, WA
National Provider Identifier
1891935177
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1820 Issued in WA
Legal business name
MARK J JENSEN OD PS
Practice address
22530 SE 64TH PL
Suite 140
Issaquah, WA 98027-8992
Phone
(425) 392-2020
NPI assigned
Feb 26, 2009
Last updated
May 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark J Jensen, O.D.NPI 1760473920
Title
President
Phone
(425) 392-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1820 WA Primary

Addresses

Primary practice location

22530 SE 64TH PL
Suite 140
Issaquah, WA 98027-8992

Mailing address

22530 SE 64TH PL
Suite 140
Issaquah, WA 98027-8992
Phone (425) 392-2020

Other names 1

  • Issaquah Optometric Center Other name

National Provider Directory

National Provider Directory

Locations

22530 SE 64th Pl
Ste 140
Issaquah, WA 98027
Phone (425) 392-2020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1891935177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22530 SE 64TH PL",
            "address_2": "SUITE 140",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278992",
            "telephone_number": "425-392-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22530 SE 64TH PL",
            "address_2": "SUITE 140",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278992",
            "telephone_number": "425-392-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J JENSEN OD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-26",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-392-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Issaquah Optometric Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.