BONNEY LAKE OPTICAL, INC (NPI# 1154478014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154478014 |
| Entity Type | Organization |
| Organization Name | BONNEY LAKE OPTICAL, INC |
| Practice Address |
21221 Hwy 410 Bonney Lake WA 98390 |
| Practice Telephone | 2538621044 |
| Mailing Telephone | 2538621044 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2013-04-15 |
| Authorized Official Name | BRUCE GERALD CUDAHY (PRESIDENT) |
| Authorized Official Telephone | 2538621044 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 1641 | WA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2009926 | 05 |
| Street Address |
21221 HWY 410 |
| City | BONNEY LAKE |
| State | WA |
| Zip Code | 98390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669996211 | Michael Johnson-money | Pharmacist | 20904 Highway-410, Bonney Lake, WA 98390 | 2017-07-26 |
| 1295150498 | Sound Associates Western Washington LLC | Hearing Instrument Specialist | 15324 Main St. E, Ste. B, Sumner, WA 98390 | 2014-02-25 |
| 1811330129 | Callie Leah Macleod | Student in an Organized Health Care Education/Training Program | 5805 Parker Rd, Sumner, WA 98390 | 2013-04-17 |
| 1699020388 | Alex George Wardle | Pharmacist | 20901 Highway 410, Bonney Lake, WA 98390 | 2012-07-18 |
| 1417102112 | Laura Christine Vandyk | Dentist | 1006 C Fryar Ave, Sumner, WA 98390 | 2008-11-21 |
| 1164631248 | Jeff Lee Sisco | Massage Therapist | 21157 State Route 410, Bonney Lake, WA 98390 | 2007-05-22 |
| 1215053764 | Assisted Living Concepts Inc | Assisted Living Facility | 5713 Parker Road, Sumner, WA 98390 | 2007-03-22 |
| 1518007350 | Julie Bush Webster | Marriage & Family Therapist | 920 Alder Avenue, Suite 203, Sumner, WA 98390 | 2007-02-08 |
| 1437248986 | Christopher John Nielsen | Dentist | 3106-e Sumner-tapps Hwy E, Sumner, WA 98390 | 2006-10-12 |
| 1508973454 | Ronald John Tracy | Dentist | 1006 B Fryar Ave, Sumner, WA 98390 | 2006-08-24 |
| Find all providers in zip 98390 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043329360 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 21302 State Route 410 East, Bonney Lake, WA 98391-8468 | 2006-08-30 |
| 1013939719 | Washington Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 9400 192nd Ave E, Bonney Lake, WA 98391-8564 | 2006-07-24 |
| 1730106865 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 19205 Sr 410 E, Bonney Lake, WA 98391-6305 | 2006-07-16 |
| 1790711489 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 20904 Hwy 410, Bonney Lake, WA 98390 | 2006-06-24 |
| 1629004403 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 21301 State Route 410 E, Bonney Lake, WA 98391 | 2006-06-24 |
| 1376688085 | Apple Physical Therapy LLC | Durable Medical Equipment & Medical Supplies | 10004 204th Ave E, Suite 3100, Bonney Lake, WA 98391-6539 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528675451 | Zoia Healthcare | Durable Medical Equipment & Medical Supplies | 12308 Ne 56th St Ste 1611, Vancouver, WA 98682-6495 | 2020-09-24 |
| 1376158725 | Wound Pros Washington | Durable Medical Equipment & Medical Supplies | 11335 Ne 122nd, Suite 105, Kirkland, WA 98034-6933 | 2020-09-12 |
| 1295352557 | North Seattle Medical Supply | Durable Medical Equipment & Medical Supplies | 19502 48th Ave W Ste B, Lynnwood, WA 98036-5507 | 2020-07-01 |
| 1407470420 | Whidbey Medical Equipment Supply LLC | Durable Medical Equipment & Medical Supplies | 1705 Main Street, Freeland, WA 98249 | 2020-06-05 |
| 1851912828 | Washington Cvs Pharmacy L L C | Durable Medical Equipment & Medical Supplies | 272 116th Ave Ne, Bellevue, WA 98004-5213 | 2020-05-01 |
| 1104454925 | Itoro Akpan Ukpe | Durable Medical Equipment & Medical Supplies | 6852 Montevista Dr Se, Auburn, WA 98092-8223 | 2020-03-28 |
| 1386271575 | Tegan Scientific LLC | Durable Medical Equipment & Medical Supplies | 12206 Se 38th St, Bellevue, WA 98006-1133 | 2020-03-26 |
| 1235764473 | Tactical Rehabilitation Inc | Durable Medical Equipment & Medical Supplies | 15110 Union Ave Sw, Lakewood, WA 98498-2093 | 2020-03-09 |
| 1255966925 | Uniplex Construction, LLC | Durable Medical Equipment & Medical Supplies | 14737 Ne 87th St, Redmond, WA 98052-6500 | 2020-03-03 |
| 1437783156 | Medella Northwest | Durable Medical Equipment & Medical Supplies | 2130 160th Pl Sw, Lynnwood, WA 98087-2539 | 2020-03-03 |
| Find all providers with the same taxonomy | ||||
| City | BONNEY LAKE |
| Zip Code | 98390 |
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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.