Provider Demographics
NPI:1992989248
Name:WINN, KIT CHRISTIAN A
Entity type:Individual
Prefix:MR
First Name:KIT CHRISTIAN
Middle Name:A
Last Name:WINN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:KIT CHRISTIAN
Other - Middle Name:A
Other - Last Name:WINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LDO
Mailing Address - Street 1:16150 NE 85TH ST
Mailing Address - Street 2:#107
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3539
Mailing Address - Country:US
Mailing Address - Phone:425-556-0202
Mailing Address - Fax:425-556-0202
Practice Address - Street 1:16150 NE 85TH ST
Practice Address - Street 2:#107
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3539
Practice Address - Country:US
Practice Address - Phone:425-556-0202
Practice Address - Fax:425-556-0202
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2113156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician