ANGELICA ROSE SUP (NPI# 1366522633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366522633 |
| Entity Type | Individual |
| Full Name | ANGELICA ROSE SUP |
| Credential | O.D. |
| Practice Address |
21911 76th Ave W Suite 101 Edmonds WA 98026-7903 |
| Practice Telephone | 4257747723 |
| Practice Fax Number | 4257782788 |
| Mailing Telephone | 4257747723 |
| Mailing Fax Number | 4257782788 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OD00003975 | WA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I PROVIDER NUMBER | 0202735 | 01 |
| WA | REGENCE PROVIDER NUMBER | 2161SU | 01 |
| Street Address |
21911 76TH AVE W SUITE 101 |
| City | EDMONDS |
| State | WA |
| Zip Code | 98026-7903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326099078 | Maurene P Cronyn | Family Medicine | 21911 76th Ave W, #110, Edmonds, WA 98026-7903 | 2006-05-15 |
| 1538614425 | Backman Colic & Patel Pllc | Dentist | 21911 76th Ave W, Suite #206, Edmonds, WA 98026-7918 | 2016-08-20 |
| 1285978452 | Chelsea Murphy | Dietitian, Registered | 21911 76th Ave W, Suite 200, Edmonds, WA 98026-7918 | 2012-11-12 |
| 1124382676 | Emmy Nakasu Davison | Family Medicine | 21911 76th Ave W, Suite 110, Edmonds, WA 98026-7918 | 2012-06-29 |
| 1205190998 | Emily Nel Peterson | Family Medicine | 21911 76th Ave W, Suite 110, Edmonds, WA 98026-7918 | 2012-06-27 |
| 1740565985 | Barbara Ann Menia | Dietitian, Registered | 21911 76th Ave W, Suite 106, Edmonds, WA 98026-7918 | 2011-10-19 |
| 1649575820 | Joshua M Kennedy | Specialist/Technologist, Other | 21911 76th Ave W, Suite 106, Edmonds, WA 98026-7918 | 2011-01-19 |
| 1861708281 | Swedish Edmonds | Family Medicine | 21911 76th Ave W, Suite 110, Edmonds, WA 98026-7507 | 2010-08-23 |
| 1912167842 | Samuel K Seto Md Pllc | Clinic/Center | 21911 76th Ave W, Suite 202, Edmonds, WA 98026-7918 | 2008-06-13 |
| 1659563260 | Angela Jeanette Sparks | Family Medicine | 21911 76th Ave W, #110, Edmonds, WA 98026-7918 | 2007-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833526 | Enas Hamid Albar | Student in an Organized Health Care Education/Training Program | 7500 212th Street S.w., Suite 205, Edmonds, WA 98026 | 2020-08-26 |
| 1215579453 | Kailey Anne Matulich | Technician | 21630 84th Ave W, Edmonds, WA 98026 | 2019-10-09 |
| 1154962124 | Steven M Weible | Technician | 21630 84th Ave, Edmonds, WA 98026 | 2019-10-01 |
| 1053767293 | Hyo Kyung Kim | Pharmacist | 22618 Hwy 99 Ste 109, Edmonds, WA 98026 | 2016-05-06 |
| 1679947956 | Lucilyn Lumio | Occupational Therapist | 21008 76th Avenue W, Edmonds, WA 98026 | 2015-11-24 |
| 1669844205 | Kathleen Schmitt | Pharmacist | 21601 76th Ave West, Edmonds, WA 98026 | 2015-10-22 |
| 1689087967 | Ronald Paul Meagher | Anesthesiology | 7305 173rd St Sw, Edmonds, WA 98026 | 2014-06-04 |
| 1598194342 | Allison Alberton | Surgery | 7315 212th St Sw Ste 201, Edmonds, WA 98026 | 2013-11-02 |
| 1356681019 | Tekle Zewolday Eysadik | Registered Nurse | 8102 - 226 St Sw, Edmonds, WA 98026 | 2013-02-18 |
| 1447557087 | Diane Taylor | Counselor | 20903 70th Ave W., Edmonds, WA 98026 | 2011-02-17 |
| Find all providers in zip 98026 | ||||
| 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 |
|---|---|---|---|---|
| 1396975074 | Chris Wallace, Inc | Optometrist | 8624-202nd Street Sw, Edmonds, WA 98026-6644 | 2009-07-16 |
| 1437225430 | Edmonds Vision Center Ps Inc | Optometrist | 201 5th Ave S Ste 102, Edmonds, WA 98020 | 2006-11-28 |
| 1730279498 | Michael W Medin | Optometrist | 7315 212th St Sw Ste 205, Edmonds, WA 98026-7610 | 2006-10-13 |
| 1003804014 | Tony D. Pool | Optometrist | 543 Main St, Suite C, Edmonds, WA 98020-3162 | 2005-10-12 |
| 1457345563 | Randy Lai Yuu Wong | Optometrist | 22511 Highway 99, Ste 112, Edmonds, WA 98026-8398 | 2005-09-02 |
| 1922123124 | Visionaire, LLC | Optometrist | 22511 Highway 99, Suite 112, Edmonds, WA 98026-8379 | 2007-03-20 |
| 1144384520 | Benjamin M Stoebner | Optometrist | 7315 212th St Sw Ste 205, Edmonds, WA 98026-7610 | 2006-12-20 |
| 1174613715 | Glen R Owen | Optometrist | 7315 212th St Sw, Ste 200, Edmonds, WA 98026-7610 | 2006-10-13 |
| 1558451369 | Edmonds Eyecare Associates Inc Ps | Optometrist | 7315 212th St Sw, Suite 200, Edmonds, WA 98026-7610 | 2006-10-13 |
| 1588754253 | Bryan S Karrick | Optometrist | 7315 212th St Sw Ste 205, Edmonds, WA 98026-7610 | 2006-10-13 |
| Find all providers in EDMONDS | ||||
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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.