Provider Demographics
NPI:1932289188
Name:CRISSY, FRANKLIN E (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:E
Last Name:CRISSY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3015 SQUALICUM PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1945
Mailing Address - Country:US
Mailing Address - Phone:360-733-4800
Mailing Address - Fax:360-733-2879
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-733-4800
Practice Address - Fax:360-733-2879
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOD00001863152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2015097Medicaid
WA2015097Medicaid
WAU10872Medicare UPIN