Provider Demographics
NPI:1942212089
Name:CLINE, KARI A (OD)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:A
Last Name:CLINE
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 1:114 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-2019
Mailing Address - Country:US
Mailing Address - Phone:503-874-2020
Mailing Address - Fax:503-873-6977
Practice Address - Street 1:114 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-2019
Practice Address - Country:US
Practice Address - Phone:503-874-2020
Practice Address - Fax:503-873-6977
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR 3127ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR027948Medicaid
ORV07312Medicare ID - Type Unspecified
OR139622Medicare PIN
OR027948Medicaid