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NPI Code Detail

MEDICARE: JASON RANDALL LEWIS D.O.

MEDICARE: JASON RANDALL LEWIS D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianR6036TX
2207WX0200XOphthalmic Plastic and Reconstructive Surgery PhysicianR6036TX
3207WX0200XOphthalmic Plastic and Reconstructive Surgery PhysicianOP61442310WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1386074402OTHERTXCSHCN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912323478
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON RANDALL LEWIS D.O.
Provider Business Mailing Address
First Line : 1821 44TH STREET CT NW
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-1427
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9040A JACKSON AVE
Second Line :
City : TACOMA
State : WA
Zip : 98431-0001
Country : US
Telephone Number : 253-968-1110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2014
Last Update Date : 01/13/2026

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