MAYEMURA, INC. (NPI# 1093098402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093098402 |
| Entity Type | Organization |
| Organization Name | MAYEMURA, INC. |
| Other Organization Name | MOUNTLAKE TERRACE EYE CARE |
| Practice Address |
23009 56th Ave W Ste. A Mountlake Terrace WA 98043-4713 |
| Mailing Address |
14050 Juanita Dr Ne Ste. A Kirkland WA 98034-9708 |
| Practice Telephone | 4257780133 |
| Practice Fax Number | 4257788833 |
| Mailing Telephone | 4258202020 |
| Mailing Fax Number | 4258219576 |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |
| Authorized Official Name | DR. KEN KENJI MAYEMURA (OWNER / OPTOMETRIC PHYSICIAN) |
| Authorized Official Telephone | 4257780133 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Mountlake Terrace Eye Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689857690 | Mayemura, Inc. | Optometrist | 9610 Evergreen Way, Ste. A, Everett, WA 98204-7102 | 2007-12-12 |
| 1427299056 | Mayemura, Inc. | Optometrist | 14050 Juanita Dr Ne, Ste. A, Bothell, WA 98011-5308 | 2009-03-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | MAYEMURA, INC, P S | 3202 W Mcgraw St, Seattle, WA 98199-3208 |
| Street Address |
23009 56TH AVE W STE. A |
| City | MOUNTLAKE TERRACE |
| State | WA |
| Zip Code | 98043-4713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316085822 | Gordon George Dewey | Chiropractor | 23009 56th Ave W, Suite B, Mountlake Terrace, WA 98043-4713 | 2007-02-05 |
| 1013189984 | Mountlake Terrace Eye and Contact Lens Clinic | Optometrist | 23009 56th Ave W, Ste A, Mountlake Terrace, WA 98043-4713 | 2008-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785357 | Maria Angelica Lopez | Counselor | 22815 Lakeview Dr Apt 'g' - 308, Mountlake Terrace, WA 98043 | 2020-06-17 |
| 1447891411 | Juana Antonia Hartley | Technician | 4808 221st St. Sw, Mountlake Terrace, WA 98043 | 2019-10-01 |
| 1437709961 | Jamil Vaughn Shoot | Acupuncturist | 21705 56th Ave W, Mount Lake Terrace, WA 98043 | 2019-09-17 |
| 1942709449 | Julie A Hill | Registered Nurse | 22001 44th Ave W, Mountlake Terrace, WA 98043 | 2018-02-09 |
| 1205285004 | Preeti Suryakumar | Occupational Therapist | 23008 56th Ave West, Vineyard Park At Mountlake Terrace, Mountlake Terrace, WA 98043 | 2016-06-13 |
| 1467819623 | Liisa Marlene Geyer | Social Worker | 6021 244th St Sw # 400, Mountlake Terrace, WA 98043 | 2016-01-19 |
| 1346611696 | Isaiah Johnson | Massage Therapist | 21604 66th Ave N, #a, Mountlake Terrace, WA 98043 | 2015-10-13 |
| 1417343260 | Sunanta Angela Astorga | Counselor | 6021 244th St Sw #400, Mountlake Terrace, WA 98043 | 2015-04-08 |
| 1366835746 | Teresa Antoinette White | Chiropractor | 6603 220th St. Sw Suite 100, Mountlake Terrace, WA 98043 | 2015-03-10 |
| 1508156647 | Monica Jean Scott | Massage Therapist | 23009-56 Ave W # B, Mountlake Terrace, WA 98043 | 2011-04-11 |
| Find all providers in zip 98043 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588619670 | John E Clavadetscher | Optometrist | 21005 44th Ave W, Suite 102, Mountlake Terrace, WA 98043-3584 | 2006-05-24 |
| 1013189984 | Mountlake Terrace Eye and Contact Lens Clinic | Optometrist | 23009 56th Ave W, Ste A, Mountlake Terrace, WA 98043-4713 | 2008-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544101 | Destiny Nicole Mccoy | Optometrist | 19400 108th Ave Se Ste 202, Kent, WA 98031-0108 | 2020-09-25 |
| 1598370371 | Optometry Medical Group Inc | Optometrist | 1721 22nd Ave, Seattle, WA 98122-3324 | 2020-09-09 |
| 1962011320 | Kristine Marie Hackett | Optometrist | 19301 Se 34th St Ste 104, Camas, WA 98607-8881 | 2020-07-30 |
| 1245857044 | Minha Lee | Optometrist | 1468 158th Pl Ne, Bellevue, WA 98008-2782 | 2020-06-29 |
| 1437774734 | Vision Plus of Barkley Pllc | Optometrist | 2900 Woburn St Ste 101, Bellingham, WA 98226-3865 | 2020-06-11 |
| 1558985671 | Tiffany Lundberg | Optometrist | 2010 W Lincoln Ave Ste 1, Yakima, WA 98902-2413 | 2020-06-04 |
| 1801423041 | Jayeon Vision | Optometrist | 13909 Meridian E Ste A3, Puyallup, WA 98373-9180 | 2020-03-26 |
| 1124653464 | James Phelan | Optometrist | 14 N. Vernon Ave., Deer Park, WA 99006 | 2020-03-06 |
| 1942832845 | Trinity Vision Pllc | Optometrist | 4750 N Division St Ste 282, Spokane, WA 99207-1433 | 2020-02-07 |
| 1104464536 | Washington Eyes, LLC | Optometrist | 5011 W Lowell Ave Ste 120, Spokane, WA 99208-8587 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTLAKE TERRACE |
| Zip Code | 98043 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.