Provider Demographics
NPI:1376719591
Name:BIGGEE, KRISTIN SUSANNE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:SUSANNE
Last Name:BIGGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 SW TERWILLIGER BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4146
Mailing Address - Country:US
Mailing Address - Phone:503-494-3000
Mailing Address - Fax:
Practice Address - Street 1:3375 SW TERWILLIGER BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4146
Practice Address - Country:US
Practice Address - Phone:503-494-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD69684207W00000X
ORMD162073207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD418745800Medicaid
MD178926YALFMedicare PIN
MD171377ZFRZMedicare PIN
MD171377ZFXBMedicare PIN