Provider Demographics
NPI:1376878009
Name:MATTIONE, CRISTIN (OD)
Entity Type:Individual
Prefix:DR
First Name:CRISTIN
Middle Name:
Last Name:MATTIONE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 AURORA AVE N APT 406
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4358
Mailing Address - Country:US
Mailing Address - Phone:913-909-9788
Mailing Address - Fax:
Practice Address - Street 1:16006 ASH WAY STE 101
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-6352
Practice Address - Country:US
Practice Address - Phone:425-787-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD 60285868152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy