NPIMap

Organization Active NPI

Mill Creek Family Eyewear

  • Optometrist
  • Mill Creek, WA
National Provider Identifier
1922633270
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MILL CREEK FAMILY EYEWEAR
Practice address
16708 Bothell Everett Hwy Ste 103
Mill Creek, WA 98012-6345
Phone
(425) 481-4440
Fax
(425) 481-4450
NPI assigned
Mar 6, 2020
Last updated
Mar 6, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
STEVEN A. DAVIS. O.D., P.S.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Authorized official

Name
Steven A Davis, ODNPI 1619060936
Title
Owner
Phone
(425) 481-4440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

16708 Bothell Everett Hwy Ste 103
Mill Creek, WA 98012-6345

Mailing address

16708 Bothell Everett Hwy Ste 103
Mill Creek, WA 98012-6345
Phone (425) 480-3111

Other practice location 1

16708 Bothell Everett Hwy Ste 103
Mill Creek, WA 98012-6345
Phone (425) 480-3111

Other identifiers 1

IdentifierTypeStateIssuer
1619060936OtherWANPI

Other names 1

  • Mill Creek Family Eye Center Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2168441Mill Creek Family Eye Center16708 Bothell-Everett Hwy Ste 103, Mill Creek, WA 98012Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Part of
Steven a Davis OD PS

Locations

16708 Bothell Everett Hwy
Ste 103
Mill Creek, WA 98012
Phone (425) 480-3111

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1922633270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16708 BOTHELL EVERETT HWY STE 103",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126345",
            "telephone_number": "425-480-3111",
            "fax_number": "425-481-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16708 BOTHELL EVERETT HWY STE 103",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126345",
            "telephone_number": "425-481-4440",
            "fax_number": "425-481-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16708 Bothell Everett Hwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980126345",
            "country_code": "US",
            "telephone_number": "425-480-3111",
            "fax_number": "425-481-4450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MILL CREEK FAMILY EYEWEAR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEVEN A. DAVIS. O.D., P.S.",
        "enumeration_date": "2020-03-06",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-481-4440",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619060936",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mill Creek Family Eye Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.