Kathleen R Wong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3268 Issued in WA

Practice address

402 Main St
Edmonds, WA 98020-3138

Phone

(425) 771-7772

Fax

(425) 775-9973

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Kathleen R Solum Professional name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edmonds Vision Center, P.S., Inc.Group PAC ID 3971693599, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edmonds Vision Center PS Inc

  • Optometrist
  • Edmonds, WA
  • NPI 1437225430
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1962503227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 5TH AVE S",
            "address_2": "STE 102",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203646",
            "telephone_number": "425-771-7772",
            "fax_number": "425-775-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MAIN ST",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203138",
            "telephone_number": "425-771-7772",
            "fax_number": "425-775-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KATHLEEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024537",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0149513",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "SOLUM",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Radu V Wolf, DDS
• Wolf,D.D.S., P.S.
• Melissa H Wolfang, LMP
• Agnes Wong, MD
• Arthur Y Wong, O.D.
• Michael John Wong, PHARMD
• Nga CHI Wong
• Randy Lai Yuu Wong, O.D.
• Thu L Wong, PHARM.D.
• Mya Lynn Wood

• 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 Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.