Spokane Optical Company LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

602617024 Issued in WA

Legal business name

SPOKANE OPTICAL COMPANY LLC

Practice address

16201 E Indiana Ave
5000
Spokane Valley, WA 99216-2830

Phone

(509) 924-7271

Fax

(509) 928-7802

NPI assigned

Aug 21, 2012

Organization subpart

No

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

Authorized official

Name

Randall K Jacobson, MD

Title

Physician

Phone

(509) 456-0107

Specialties & licenses 1

Addresses

Other names 1

• Spokane Optical Company Doing business as

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

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1972851020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16201 E INDIANA AVE",
            "address_2": "5000",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162830",
            "telephone_number": "509-924-7271",
            "fax_number": "509-928-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16201 E INDIANA AVE",
            "address_2": "5000",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162830",
            "telephone_number": "509-924-7271",
            "fax_number": "509-928-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOKANE OPTICAL COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-21",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "509-456-0107",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WA",
            "license": "602617024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spokane Optical Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Spokane Internal Medicine, P.S.
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• Spokane of Olympus, LLC
• Spokane Oms
• Spokane Oral and Maxillofacial Surgery ASC
• Spokane Oral Surgery ASC
• Spokane Podiatry PS
• Spokane Podiatry PS
• Spokane River Birth Center

• Eyewear Supplier in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Eyewear Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.