DR. JACLYN T PHAN (NPI# 1114078235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114078235 |
| Entity Type | Individual |
| Full Name | DR. JACLYN T PHAN |
| Credential | O.D. |
| Practice Address |
1912 201st Pl Se Suite 204 Bothell WA 98012-8570 |
| Practice Telephone | 4254856812 |
| Mailing Telephone | 4254856812 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-11-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
3357 | WA | Eye and Vision Services Providers |
| Street Address |
1912 201ST PL SE SUITE 204 |
| City | BOTHELL |
| State | WA |
| Zip Code | 98012-8570 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437330123 | Dr. Jaclyn Phan & Associates | Clinic/Center | 1912 201st Pl Se, Suite 204, Bothell, WA 98012-8570 | 2007-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502032 | Malia Van-frances Chase | Behavioral Analyst | 18311 Bothel-everett Hwy, Suite 260, Bothell, Wa, WA 98012 | 2020-09-14 |
| 1154951804 | Thea E Byrne | Physical Therapist | 6030 Bothell Everett Hwy, #140, Mill Creek, WA 98012 | 2020-01-22 |
| 1861975526 | Jenifer Rae Denormandie | Pharmacist | 14529 North Creek Drive Apt B210, Mill Creek, WA 98012 | 2018-09-10 |
| 1780161760 | Azadeh Fariba | Naturopath | 15411 40th Dr Se, Bothell, WA 98012 | 2018-07-23 |
| 1720572902 | Rickey Lee Mcgregor | Counselor | 16300 Mill Creek Blvd, Suite 204, Mill Creek, WA 98012 | 2018-06-20 |
| 1306349865 | Rudi Lauren Romaine | Behavioral Analyst | 18311 Bothell-everett Hwy, Suite 260, Bothell, WA 98012 | 2018-03-12 |
| 1164961025 | Wickler Behavioral Consulting | Behavioral Analyst | 632 182nd Street Se, Bothell, WA 98012 | 2017-02-13 |
| 1588026413 | Nathan Earl Crawford | Massage Therapist | 18930 Bothell Everett Hwy, D302, Bothell, WA 98012 | 2016-03-21 |
| 1144618083 | Jocelyn Enabulele | Counselor | 19105 Waxen Road, Bothell, WA 98012 | 2014-12-30 |
| 1124426846 | Teeth R Us | Dentist | 1908 201 Pl Se Suite #201, Bothell, WA 98012 | 2014-12-11 |
| Find all providers in zip 98012 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396896833 | Elizabeth Y. Chang | Optometrist | 10202 Ne 185th St, Bothell, WA 98011-3456 | 2007-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639314206 | Vision Clinic Inc | Optometrist | 4008 Lovell Rd, Wenatchee, WA 98801 | 2008-12-10 |
| 1689857690 | Mayemura, Inc. | Optometrist | 9610 Evergreen Way, Ste. A, Everett, WA 98204-7102 | 2007-12-12 |
| 1023221132 | Cindy Hung | Optometrist | 407 Baker Blvd, Tukwila, WA 98188-2906 | 2007-05-07 |
| 1316164965 | Scott David Hansen Od PC | Optometrist | 12120 E Mission Ave Ste 2, Spokane Valley, WA 99206-5378 | 2007-04-18 |
| 1689898777 | Eyecare Partners, Pllc | Optometrist | 126 E Second Street, North Bend, WA 98045 | 2007-04-12 |
| 1831212851 | John A Harden | Optometrist | 16821 Smokey Point Blvd # 314, Arlington, WA 98223-8407 | 2007-04-06 |
| 1811023732 | Longview Eye & Vision | Optometrist | 180 3rd Street, Cathlamet, WA 98612 | 2007-02-26 |
| 1245365519 | Joseph Wallace Braun | Optometrist | 4750 N Division St Ste 126, Northtown Vision Clinic, Spokane, WA 99207-1406 | 2007-02-23 |
| 1396807947 | Lisa Ann Depietto | Optometrist | 15118 Main St, Suite 600, Mill Creek, WA 98012-1653 | 2006-12-13 |
| 1417032590 | Vision Care Associates Pllc | Optometrist | 207 Yelm Ave W, Yelm, WA 98597-8652 | 2006-10-26 |
| Find all providers with the same taxonomy | ||||
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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.