Jaclyn T. Phan, O.D.
NPI 1114078235ActiveIndividual· Optometrist, Corneal and Contact Management· Bothell, WA
Optometrist, Corneal and Contact Management (O.D.) in Bothell, Washington, licensed in WA, with an NPI issued in January 2007. Enrolled in Medicare as practitioner - optometry.
Overview
| NPI | 1114078235 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | O.D. |
| Sole proprietor | Yes |
| NPI issued | Jan 16, 2007 |
| Last updated in NPPES | Nov 23, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist, Corneal and Contact Management Primary | 152WC0802X | 3357 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Optometry (WA) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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