Provider Demographics
NPI:1326041666
Name:BARRY, MARK CHRISTOPHER (OD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CHRISTOPHER
Last Name:BARRY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:M
Other - Middle Name:CHRIS
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:910 N 32ND ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-2131
Mailing Address - Country:US
Mailing Address - Phone:425-271-6420
Mailing Address - Fax:
Practice Address - Street 1:1837 156TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4387
Practice Address - Country:US
Practice Address - Phone:425-643-2020
Practice Address - Fax:425-643-0859
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1758TX152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2015857Medicaid
U12895Medicare UPIN
AB21364Medicare ID - Type Unspecified
WA2015857Medicaid