Active NPI
Jungbin Jay Yim, L.D.O.
- Optician
- Lynnwood, WA
National Provider Identifier
1992989172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO00001924
- Practice address
- 2215 180TH St SW
Lynnwood, WA 98037-7910 - Phone
- (425) 245-3446
- Fax
- (425) 745-2379
- NPI assigned
- Dec 24, 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | DO00001924 | WA | Primary |
Addresses
Primary practice location
2215 180TH St SW
Lynnwood, WA 98037-7910
Mailing address
2215 180TH St SW
Lynnwood, WA 98037-7910
Phone (425) 245-3446
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO00001924 | WA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198454400000",
"number": "1992989172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 180TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980377910",
"telephone_number": "425-245-3446",
"fax_number": "425-745-2379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 180TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980377910",
"telephone_number": "425-245-3446",
"fax_number": "425-745-2379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YIM",
"first_name": "JUNGBIN",
"middle_name": "JAY",
"name_prefix": "Mr.",
"credential": "L.D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-24",
"last_updated": "2007-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "WA",
"license": "DO00001924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.