Provider Type Icon

SUSAN P WYNNE O.D. NPI 1962448621


NPI Information

NPI: 1962448621
Provider Name: SUSAN P WYNNE, O.D.
Classification: Optometrist - 152WC0802X
Entity Type: Individual

Specialization: Corneal and Contact Management

PECOS Registration: Yes

Address:
8309 165TH AVE NE
SUITE 102
REDMOND, WA
ZIP 98052
Phone: (425) 882-2923
Get Directions

Susan P Wynne, O.D. is a corneal and contact management optometrist in Redmond, WA with 43 years of experience. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. Susan P Wynne, O.D. NPI is 1962448621. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY
Graduation Year:1981

The provider's business location address is:

8309 165TH AVE NE
SUITE 102
REDMOND, WA
ZIP 98052-939
Phone: (425) 882-2923
Fax: (425) 869-5063

The NPI 1962448621 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 6/21/2006 and was last updated on 7/8/2007.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152WC0802XOptometristCorneal and Contact Management3012WASHINGTONYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1AB00439MEDICARE ID-TYPE UNSPECIFIEDWASHINGTON
22022135MEDICAIDWASHINGTON
3T10525MEDICARE UPINWASHINGTON

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: 5/5/2024

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.