Eagle Eye Vision Care PS

Primary specialty

OptometristTaxonomy code 152W00000X

License

WA1675TX Issued in WA

Legal business name

EAGLE EYE VISION CARE PS

Practice address

17320 135TH Ave NE Ste D
Woodinville, WA 98072-8565

Phone

(425) 398-1862

NPI assigned

Nov 1, 2007

Organization subpart

No

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

Authorized official

Name

Kerri W. Scarbrough, O.D.

Title

President

Phone

(425) 398-1862

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1982883302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17320 135TH AVE NE STE D",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728565",
            "telephone_number": "425-398-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17320 135TH AVE NE STE D",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728565",
            "telephone_number": "425-398-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE EYE VISION CARE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "SCARBROUGH",
        "authorized_official_first_name": "KERRI",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-398-1862",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "WA1675TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023877",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny Jelan Dry, RN
• Lauren Dudugjian, MS-LMFT, MDIV
• Andrew Michael Dujenski, BS, DPT
• Melinda Dunphy, PTA
• Grace T. Dy, MD
• Eric Eagleson
• Eastside Psychological Associates PLLC
• Eckland PLLC
• Daryl Bruce Eckland, D.D.S.
• Keagan A Eckland, D.D.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.