Active NPI
Stephen William Hartung, O.D.
- Optometrist
- Lakewood, WA
National Provider Identifier
1962544023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00001484
- Practice address
- The Vision Center
7001 Bridgeport Way W
Lakewood, WA 98499 - Phone
- (253) 512-0965
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00001484 | WA | Primary |
Addresses
Primary practice location
The Vision Center
7001 Bridgeport Way W
Lakewood, WA 98499
Mailing address
5824 Boulevard Extension Rd SE
Olympia, WA 98501-4701
Phone (360) 923-1611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2003655 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OD00001484 | WA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962544023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5824 BOULEVARD EXTENSION RD SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985014701",
"telephone_number": "360-923-1611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "THE VISION CENTER",
"address_2": "7001 BRIDGEPORT WAY W",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "98499",
"telephone_number": "253-512-0965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTUNG",
"first_name": "STEPHEN",
"middle_name": "WILLIAM",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD00001484",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2003655",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.