DR. JOHN BOWEN EASTLAKE (NPI# 1134119068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134119068 |
| Entity Type | Individual |
| Full Name | DR. JOHN BOWEN EASTLAKE |
| Credential | O.D. |
| Practice Address |
Madigan Army Medical Center 9040 Jackson Ave Joint Base Lewis Mcchord WA 98431 |
| Practice Telephone | 2539683760 |
| Mailing Telephone | 2539683760 |
| Enumeration Date | 2005-10-23 |
| Last Update Date | 2019-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1830DT | KY | Eye and Vision Services Providers |
| Street Address |
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE |
| City | JOINT BASE LEWIS MCCHORD |
| State | WA |
| Zip Code | 98431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| 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 |
|---|---|---|---|---|
| 1801331541 | Miranda Cannon Pllc | Optometrist | 504 Barnes Blvd Bldg 504, Mcchord Main Exchange Optometry Center, Joint Base Lewis Mcchord, WA 98438-1304 | 2017-01-05 |
| 1972696722 | Lisa Mapuranga | Optometrist | 2202 Ligget Ave, Joint Base Lewis Mcchord, WA 98433-2011 | 2006-10-02 |
| 1376821215 | William Eade Garrison | Optometrist | 9040 Jackson Avenue, Joint Base Lewis Mcchord, WA 98431-5741 | 2011-07-26 |
| 1912294489 | Yen D Mcindoe | Optometrist | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98433 | 2011-07-06 |
| 1346574290 | Spanaway Eyecare, P.s. | Optometrist | 2202 Ligget Ave, Joint Base Lewis Mcchord, WA 98433 | 2009-09-24 |
| 1922265172 | Jose Enrique Capo-aponte | Optometrist | 9040 Jackson Avenue Madigan Army Medical Center, Joint Base Lewis Mcchord, WA 98431-5000 | 2008-05-16 |
| 1538159355 | Keith Harvey Schmidt | Optometrist | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-1009 | 2005-10-24 |
| 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 | JOINT BASE LEWIS MCCHORD |
| Zip Code | 98431 |
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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.