Individual
KRISTI KAYLYNN POE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
820 OCEAN BEACH HWY, SUITE 100, LONGVIEW, WA 98632-4080
(360) 636-2020
(360) 425-0221
Mailing address
820 OCEAN BEACH HWY, SUITE 100, LONGVIEW, WA 98632-4080
(360) 636-2020
(360) 425-0221
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD 60099365
WA
152WC0802X
Corneal and Contact Management Optometrist
OD60099365
WA
152WL0500X
Low Vision Rehabilitation Optometrist
OD60099365
WA
152WP0200X
Pediatric Optometrist
OD60099365
WA
152WS0006X
Sports Vision Optometrist
OD60099365
WA
152WV0400X
Vision Therapy Optometrist
OD60099365
WA
152WX0102X
Occupational Vision Optometrist
OD60099365
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2006635
—
WA
01
—
50D2022229
CLIA#
WA
Enumeration date
05/11/2009
Last updated
05/02/2011
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