| NPI | 1154478014 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2007-01-04 |
| Last Updated | 2023-01-31 |
| Authorized Official | Sean Cudahy CFO Phone: 2537508135 |
| Mailing Address | 9801 204th Ave E Bonney Lake, WA 98391-6559 United States Phone: (537) 508-1352 | Fax: (253) 750-8136 📍 View Map |
| Primary Practice Address | 9801 204th Ave E Bonney Lake, WA 98391-6559 United States Phone: (253) 750-8135 | Fax: (253) 750-8136 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | WA | 2009926 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 332B00000X – Durable Medical Equipment & Medical Supplies | WA | 1641 |
| Yes | 152W00000X – Optometrist | — | — |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1154478014
Bonney Lake Optical, Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1154478014. The primary specialty listed is Optometrist. The organization is located in Bonney Lake, WA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-01-04. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1154478014?
NPI 1154478014 belongs to Bonney Lake Optical, Inc, a Optometrist in Bonney Lake, WA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1154478014 active?
The current status of NPI 1154478014 in the NPPES registry is Active. The record was last updated on 2023-01-31.
What specialty is NPI 1154478014?
NPI 1154478014 is classified under the taxonomy Optometrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1154478014?
You can verify NPI 1154478014 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1154478014?
The primary practice address on file for NPI 1154478014 is 9801 204th Ave E, Bonney Lake, WA 98391-6559. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1154478014 issued?
NPI 1154478014 was first issued (enumerated) on 2007-01-04. The NPPES record was last updated on 2023-01-31.
Practice Location Map
Bonney Lake Optical, Inc is located at 9801 204th Ave E, Bonney Lake, WA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Bonney Lake Optical, Inc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1154478014. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 1641 | WA |