Shoreline Eyecare PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

60293866 Issued in WA

Legal business name

SHORELINE EYECARE PC

Practice address

18021 15TH Ave NE
Suite 100
Shoreline, WA 98155-3806

Phone

(206) 367-8883

Fax

(206) 913-2915

NPI assigned

Jul 31, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Erika Tydor, O.D.NPI 1407119001

Title

Optometrist

Phone

(314) 541-6529

Specialties & licenses 1

Addresses

Other names 1

• Erika Tydor OD Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erika Tydor, O.D.

  • Optometrist
  • Shoreline, WA
  • NPI 1407119001
  Medicare reassignment NPD Authorized official
• Irene Chen, OD

  • Optometrist
  • Shoreline, WA
  • NPI 1952315764
  NPD

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1972989069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2558 76TH AVE SE APT 371",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403785",
            "telephone_number": "314-541-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18021 15TH AVE NE",
            "address_2": "SUITE 100",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981553806",
            "telephone_number": "206-367-8883",
            "fax_number": "206-913-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "TYDOR",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "314-541-6529",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60293866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Erika Tydor OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Shim, RN
• Kyung Lim Shin, L.AC, DAOM
• Nina Eileen Shoop
• Anna Rose Shope, MD
• Shoreline Community College
• Shoreline Fire Department
• Shoreline Fire Department Regional Fire Authority
• Shoreline Natural Medicine Clinic, Inc
• Shoreline Nutrition PNW
• Shoreline of Cascadia, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.