Provider Demographics
NPI:1568816718
Name:THOMPSON, KRISTINE (OD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:THOMPSON
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 1:7808 N DIVISION ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6780
Mailing Address - Country:US
Mailing Address - Phone:509-795-2289
Mailing Address - Fax:
Practice Address - Street 1:7808 N DIVISION ST STE 2
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6780
Practice Address - Country:US
Practice Address - Phone:509-795-2289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60769338152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist