Visionaire, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003999 Issued in WA

Legal business name

VISIONAIRE, LLC

Doing business as

Visionaire Eyecare

Practice address

22511 Highway 99
Suite 112
Edmonds, WA 98026-8379

Phone

(425) 670-9888

Fax

(425) 670-2402

NPI assigned

Mar 20, 2007

Last updated

Jul 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randy Ly Wong, O.D.NPI 1457345563

Title

President & Optometric Physician

Phone

(206) 390-8089

Specialties & licenses 1

Addresses

Other names 1

• Visionaire Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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.

• Randy Lai Yuu Wong, O.D.

  • Optometrist
  • Edmonds, WA
  • NPI 1457345563
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1922123124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22511 HIGHWAY 99",
            "address_2": "SUITE 112",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268379",
            "telephone_number": "425-670-9888",
            "fax_number": "425-670-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22511 HIGHWAY 99",
            "address_2": "SUITE 112",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268379",
            "telephone_number": "425-670-9888",
            "fax_number": "425-670-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONAIRE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "LY",
        "authorized_official_title_or_position": "PRESIDENT & OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "206-390-8089",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visionaire Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gavin Versi
• Christine Vervitsiotis, MS, LMHC
• Sandra L Vik, MSW
• Kristen Villanueva
• Yosmara Villazon
• Emily Vo, PHARMD
• Carlo Eugenio Voli
• Giacinta Vosika, LMP
• Sharon Lee Waatti, LMP
• Kayla Wagner

• Optometrist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.