PACIFIC RETINA CENTER PLLC (NPI# 1184191603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184191603 |
| Entity Type | Organization |
| Organization Name | PACIFIC RETINA CENTER PLLC |
| Practice Address |
1412 Sw 43rd St Renton WA 98057-4803 |
| Mailing Address |
2919 W Hayes St Seattle WA 98199-4247 |
| Practice Telephone | 9107427427 |
| Mailing Telephone | 9107427427 |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-01 |
| Authorized Official Name | JAMISON R RIDGELEY (MANAGER) |
| Authorized Official Telephone | 9107427427 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PACIFIC RETINA CENTER PLLC | 1412 Sw 43rd St, Ste 206, Renton, WA 98057 |
| Street Address |
1412 SW 43RD ST |
| City | RENTON |
| State | WA |
| Zip Code | 98057-4803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487654331 | N W Eye Surgeons P C | Ophthalmology | 1412 Sw 43rd St, Suite 310, Renton, WA 98057-4803 | 2005-07-21 |
| 1568085454 | Jacqueline R. Buckley, LLC | Podiatrist | 1412 Sw 43rd St, Renton, WA 98057-4803 | 2020-05-26 |
| 1336690684 | Geoffrey Natividad | Pharmacist | 1412 Sw 43rd St, 120, Renton, WA 98057-4803 | 2016-10-21 |
| 1386195048 | Reddi Enterprises Inc | Pharmacy | 1412 Sw 43rd St, 120, Renton, WA 98057-4803 | 2016-10-18 |
| 1417405333 | Evergreen Treatment Services | Clinic/Center | 1412 Sw 43rd St, Suite 140, Renton, WA 98057-4803 | 2016-09-20 |
| 1396192803 | Concerto Medical Group of Washington, PC | General Practice | 1412 Sw 43rd St, Suite 315, Renton, WA 98057-4803 | 2016-05-16 |
| 1225421688 | Associated Valley Counseling, LLC | Counselor | 1412 Sw 43rd St, Suite 111, Renton, WA 98057-4803 | 2015-03-10 |
| 1649660853 | Lauren Rainbow | Social Worker | 1412 Sw 43rd St, Renton, WA 98057-4803 | 2015-01-26 |
| 1336539733 | Washington Center for Pain Management LLC | Anesthesiology | 1412 Sw 43rd St, Suite 110, Renton, WA 98057-4803 | 2015-01-23 |
| 1083022537 | Timothy Stewart | Counselor | 1412 Sw 43rd St, Suite 111, Renton, WA 98057-4803 | 2014-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856628 | Megan Ramaiya | Student in an Organized Health Care Education/Training Program | King Count Sexual Assault & Resource Center, 200 Mill Ave S # 10, Renton, WA 98057 | 2019-11-19 |
| 1063076255 | Breanne Michele Smiley | Specialist/Technologist | 737 Logan Ave N, Renton, WA 98057 | 2019-04-24 |
| 1093215063 | Laura Lewis | Physical Medicine & Rehabilitation | 1000 Oakesdale Ave Sw Ste 100, Renton, WA 98057 | 2018-02-16 |
| 1437676004 | Ralph William Papke Jr. | Counselor | Kaiser Permanente of Wa, 1200 Sw 27th St, Renton, WA 98057 | 2017-08-24 |
| 1487106456 | Serengeti Care Partners LLC | Community/Behavioral Health | 707 S- Grady Way, Suite 6008, Renton, WA 98057 | 2016-10-26 |
| 1548716152 | Phandinh Ngoc Nguyen | Naturopath | 330 Sw 43rd St,suite L, Renton, WA 98057 | 2016-09-01 |
| 1275905721 | Todd R Glass | Chiropractor | 1024 N 10th Pl #2306, Renton, WA 98057 | 2015-10-23 |
| 1134595341 | Have A Heart | Case Management | 151 Taylor Ave Nw, Renton, WA 98057 | 2015-08-12 |
| 1780087171 | Brianne N Lefferts | Physical Therapist | 300 Sw 7th Street, Renton, WA 98057 | 2014-09-30 |
| 1588089460 | Sound Association Western Washington LLC | Audiologist | 108 Factory Ave. N., Ste 2b, Renton, WA 98057 | 2014-02-28 |
| Find all providers in zip 98057 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1528303849 | Retina Institute, Pllc | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055-6238 | 2012-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356836357 | Summit Eye Consultants Pllc | Ophthalmology | 945 Hildebrand Ln Ne Ste 235, Bainbridge Island, WA 98110-2877 | 2018-06-22 |
| 1669590782 | Tony H. Huynh | Ophthalmology | 6100 219th St Sw Ste 280, Mountlake Terrace, WA 98043-2222 | 2007-03-27 |
| 1992040240 | Retina Specialists Northwest, Pllc | Ophthalmology | 33915 1st Way S, Ste 120, Federal Way, WA 98003-4551 | 2012-11-27 |
| 1841568946 | Proliance Surgeons, Inc., P.s. | Ophthalmology | 1750 112th Ave Ne Ste D050, Bellevue, WA 98004 | 2011-12-05 |
| 1386669562 | David N Drucker | Ophthalmology | 1530 N 115th St, Suite 105, Seattle, WA 98133-8421 | 2006-07-12 |
| 1033141007 | Todd Evan Schneiderman | Ophthalmology | 9800 Levin Rd Nw, Suite 203, Silverdale, WA 98383-7849 | 2006-07-07 |
| 1942232913 | David J Spinak | Ophthalmology | 9800 Levin Rd Nw, Ste 203, Silverdale, WA 98383-7849 | 2006-07-07 |
| 1295729010 | Adrian Eoin Omalley | Ophthalmology | 9800 Levin Rd Nw, #203, Silverdale, WA 98383-7849 | 2005-09-08 |
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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.