Blue Wave Eye Doctors Professional Limited Liability Company
Optometrist in Lynnwood, WA. Organization (NPI-2).
NPI number1972214765
StatusActive
Last updated in NPPESFeb 27, 2023
Details
- NPI
- 1972214765
- Entity type
- Organization (NPI-2)
- Legal business name
- Blue Wave Eye Doctors Professional Limited Liability Company
- Organization subpart
- No
- Enumeration date
- Dec 12, 2022
- Certification date
- Feb 27, 2023
- Last updated
- Feb 27, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Other names
- Visionworks Doctors Of Optometry (Doing Business As)
Practice location
3101 184th St Sw Ste 109&110Lynnwood, WA 98037-4846
Phone 726-444-4122
Mailing address
175 E Houston StSan Antonio, TX 78205-2299
Phone 726-444-4122
Authorized official
Dolsie McDonald
Credentialing Manager
7264444078
Is something wrong?
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All 41 Optometrist providers in Lynnwood · All 3,122 providers in Lynnwood
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