Provider Demographics
NPI:1871802579
Name:WOESNER, KRISTINA (OD)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:
Last Name:WOESNER
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 1:1103 N PINES RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4936
Mailing Address - Country:US
Mailing Address - Phone:509-926-6800
Mailing Address - Fax:
Practice Address - Street 1:1103 N PINES RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4936
Practice Address - Country:US
Practice Address - Phone:509-926-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60182619152W00000X
WA60182619152W00000X
GUOL042152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist