Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kristen Elaine Derry

Individual provider Optometrist · NPI 1730523788

Kristen Elaine Derry is an Optometry in Vancouver, Washington. Graduated from Pacific University - College of Optometry in 2014, 12 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
12
Trained at
Pacific University - College of Optometry
Licensed in
OR, WA
In the registry since
2013
Specialties on file
3
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Practice location Address checks out

12116 SE Mill Plain Blvd Ste 1
Vancouver, WA 98684-6000
Phone: (360) 719-1512
Fax: (503) 254-0576
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 60503088 (WA)
Optometrist Taxonomy 152W00000X · Licence 3579ATI (OR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1730523788
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 22, 2013
Last updated in NPPESOctober 3, 2022
Certification dateOctober 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolPACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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