Dean Riskedahl, OD, PS

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001900 Issued in WA

Legal business name

DEAN RISKEDAHL, OD, PS

Practice address

2092 32ND Ave NE
Issaquah, WA 98029-7349

Phone

(425) 861-7761

NPI assigned

May 28, 2008

Organization subpart

No

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

Authorized official

Name

Dean Riskedahl, ODNPI 1396800025

Title

Owner

Phone

(253) 520-0158

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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

• Dean Riskedahl, OD

  • Optometrist
  • Issaquah, WA
  • NPI 1396800025
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1982862868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5202",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980645202",
            "telephone_number": "253-520-0158",
            "fax_number": "253-854-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2092 32ND AVE NE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297349",
            "telephone_number": "425-861-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN RISKEDAHL, OD, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "RISKEDAHL",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-520-0158",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022929",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "22-04322",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410045719",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brunette Dawson, PH.D, LMHC
• David Forrest Dawson, LMT
• Dayspring Behavioral Health LLC
• Jennifer Anne Martinell De Alba, MA, LMHC
• Candice De Sauvage
• Suzette Debutts, MS OTR/L
• April A. Decker
• Brandi Sue Defazio, MHA, MA, LMFT
• Stacy Danae Deffner, M.A., CCC-SLP
• Christian F Deisler

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.