Individual
KEVIN LYNN WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
101 NW 12TH AVE, SUITE 101, BATTLE GROUND, WA 98604-9141
(360) 687-0755
(360) 666-8664
Mailing address
101 NW 12TH AVE, SUITE 101, BATTLE GROUND, WA 98604-9141
(360) 687-0755
(360) 666-8664
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3123
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016855
—
WA
Enumeration date
07/05/2006
Last updated
12/03/2009
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