Provider Demographics
NPI:1427007152
Name:CZIRR, KARL BRANDON (OD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:BRANDON
Last Name:CZIRR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2459 S UNION PL STE 120
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338
Mailing Address - Country:US
Mailing Address - Phone:509-737-2010
Mailing Address - Fax:509-591-0012
Practice Address - Street 1:4309 W 27TH PL
Practice Address - Street 2:SUITE 102
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-2904
Practice Address - Country:US
Practice Address - Phone:509-737-2010
Practice Address - Fax:509-737-2012
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3567TX152W00000X, 152WC0802X, 152WP0200X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA912051509OtherEMPLOYER IDENTIFICATION #
WA912051509OtherEMPLOYER IDENTIFICATION #
WAP00121187Medicare ID - Type UnspecifiedRAILROAD MEDICARE
WAGAB36165Medicare PIN