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WILBUR SUSILASATE O.D. NPI 1891783676


NPI Information

NPI: 1891783676
Provider Name: WILBUR SUSILASATE, O.D.
Classification: Optometrist - 152W00000X
Entity Type: Individual
Organization: RAINIER VALLEY OPTOMETRIC INC

PECOS Registration: Yes

Address:
7101 MARTIN LUTHER KING JR WAY S
#209
SEATTLE, WA
ZIP 98118
Phone: (206) 722-2218
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Wilbur Susilasate, O.D. is an optometrist in Seattle, WA with 24 years of experience. The provider is 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. Wilbur Susilasate, O.D. NPI is 1891783676. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA - SCHOOL OF OPTOMETRY
Graduation Year:2000

The provider's business location address is:

7101 MARTIN LUTHER KING JR WAY S
#209
SEATTLE, WA
ZIP 98118-594
Phone: (206) 722-2218
Fax: (206) 722-2211

The NPI 1891783676 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/6/2005 and was last updated on 5/29/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristOD 3608WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12029528MEDICAIDWASHINGTON
2G8805945MEDICARE PINWASHINGTON
32029262MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.