Provider Demographics
NPI:1922739200
Name:HARRELL, KALINA (OD)
Entity Type:Individual
Prefix:
First Name:KALINA
Middle Name:
Last Name:HARRELL
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 1:14700 E INDIANA AVE SPC 1008
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1841
Mailing Address - Country:US
Mailing Address - Phone:509-596-9880
Mailing Address - Fax:
Practice Address - Street 1:14700 E INDIANA AVE SPC 1008
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1841
Practice Address - Country:US
Practice Address - Phone:509-596-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-18
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61298078152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist