Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tanya Victoria Petruk, OD

Individual provider Optometrist · NPI 1487515474

Tanya Victoria Petruk, OD is an Optometry in Lacey, Washington. Qualified in 2023, 3 years ago. Practices with Aeg Washington Professional PC, a 61-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
3
Licensed in
WA
In the registry since
2025
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

8160 Freedom Ln NE Unit D
Lacey, WA 98516
Phone: (360) 455-4425
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OD.OD.70055125 (WA)

Record details

NPI number1487515474
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorYes
NPI enumeratedNovember 19, 2025
Last updated in NPPESNovember 19, 2025
Certification dateNovember 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Aeg Washington Professional Pc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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