SHANNON CHAN (OD) – Optometrist, NPI 1659194215

SHANNON CHAN (OD) is a healthcare provider. based in Mill creek, Washington. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OD61651235 (WA). The NPI Number for SHANNON CHAN (OD) is 1659194215

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON CHAN (OD)
NPI
1659194215
Phone
(425) 745-5650
Address
15808 MILL CREEK BLVD STE 110
Enumeration Date
4 November 2024
Last Update Date
12 August 2025

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
4257455650
Graduation Year
2024 (2 years ago)
PAC ID
8820505712
Group Practice PAC ID
3971762931
Professional Enrollment ID
I20250725003240
Address ID
WA980121500MI15808BLVD401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

1,098 OPTOMETRY in WA

Provider Addresses for SHANNON CHAN (OD)

  • 15808 MILL CREEK BLVD STE 110

    MILL CREEK, WA 980121500

    Phone: (425) 745-5650

    Fax: (425) 337-1342

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250725003240IOptometryWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98012)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971762931View full group profile
NameSpecialtyState
O P T O M E T R YWA
O P T O M E T R YCA
O P T O M E T R YOR
O P T O M E T R YWA

Reviews

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Frequently asked questions

Does SHANNON CHAN (OD) have a public NPI I can cite?
Public records show SHANNON CHAN (OD) under NPI 1659194215.
Quick check: is SHANNON CHAN (OD) active?
Public NPPES data shows SHANNON CHAN (OD) with an active NPI status right now.
How should patients interpret SHANNON CHAN (OD)'s specialty?
The extract shows Optometrist for SHANNON CHAN (OD). Clinical services aligned with this taxonomy classification.
Which community is linked to SHANNON CHAN (OD)?
SHANNON CHAN (OD) shows a connection to Mill Creek, Washington in registry-derived data.
Can I export SHANNON CHAN (OD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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