KENNETH D. COMMON, O.D., P.S. (NPI# 1811052798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811052798 |
| Entity Type | Organization |
| Organization Name | KENNETH D. COMMON, O.D., P.S. |
| Practice Address |
625 Black Lake Blvd Sw Suite #110 Olympia WA 98502-5066 |
| Practice Telephone | 3603572544 |
| Practice Fax Number | 3603576341 |
| Mailing Telephone | 3603572544 |
| Mailing Fax Number | 3603576341 |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KENNETH DOUGLAS COMMON (PRESIDENT) |
| Authorized Official Telephone | 3603572544 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 1155 | WA | Ambulatory Health Care Facilities |
| Street Address |
625 BLACK LAKE BLVD SW SUITE #110 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-5066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851402085 | Kenneth Douglas Common | Optometrist | 625 Black Lake Blvd Sw, Suite #110, Olympia, WA 98502-5066 | 2006-08-31 |
| 1184004749 | Joseph Beaushaw | Optometrist | 625 Black Lake Blvd Sw, Olympia, WA 98502-5066 | 2015-06-08 |
| 1780987313 | Angela Loeb, Od, Pllc | Optometrist | 625 Black Lake Blvd Sw, Suite 369, Olympia, WA 98502-5066 | 2010-12-21 |
| 1457665739 | Angela Caterina Loeb | Optometrist | 625 Black Lake Blvd Sw, Suite 369, Olympia, WA 98502-5066 | 2010-07-29 |
| 1487700407 | Dr. Dallas Carr and Associates | Clinic/Center | 625 Black Lake Blvd Sw, Suite 110, Olympia, WA 98502-5066 | 2007-01-25 |
| 1073674230 | Jay Woodworth Nelson | Optometrist | 625 Black Lake Blvd Sw, Olympia, WA 98502-5066 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
| Find all providers in zip 98502 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477035210 | Ideal Option, Pllc | Clinic/Center | 205b Lilly Rd Ne Ste C, Olympia, WA 98506-7401 | 2018-08-29 |
| 1134656135 | Providence Health & Services Washington | Clinic/Center | 1018 Capitol Way S Ste 300, Olympia, WA 98501-1212 | 2017-05-22 |
| 1861939597 | The Olympia Free Clinic | Clinic/Center | 108 State Ave Nw, Olympia, WA 98501-8249 | 2017-01-19 |
| 1689273955 | Sisu Health PC | Clinic/Center | 1824 Black Lake Blvd Sw Ste 101, Olympia, WA 98512-5714 | 2020-10-19 |
| 1215549894 | Clevenger Chiropractic Services LLC | Clinic/Center | 549 Mcphee Rd Sw, Olympia, WA 98502-5015 | 2020-08-17 |
| 1366940645 | Provasoli Chiropractic Inc. | Clinic/Center | 1018 7th Ave Se, Olympia, WA 98501-1512 | 2018-02-01 |
| 1528599685 | South Sound Vasectomy and Men's Health | Clinic/Center | 324 W Bay Dr Nw, Suite 105, Olympia, WA 98502-4926 | 2017-03-21 |
| 1760840755 | Atlas Sleep Diagnostics LLC | Clinic/Center | 3627 Ensign Rd Ne Ste A, Olympia, WA 98506-6104 | 2016-02-04 |
| 1962876540 | Wellness Navigators, Pllc | Clinic/Center | 1804 Black Lake Blvd Sw, Suite 101, Olympia, WA 98512-5633 | 2015-11-19 |
| 1487047601 | Rainier Family Practice, Pllc | Clinic/Center | 1408 State Ave Ne Ste 111, Olympia, WA 98506-4481 | 2015-03-12 |
| Find all providers in OLYMPIA | ||||
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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.