Kristen Elaine Derry
Optometrist · Vancouver, WA
At a glance
12116 Se Mill Plain Blvd Ste 1, Vancouver, WA 98684-6000
NPPES record updated Oct 3, 2022. Public records can lag behind changes at a practice.
Before you call: a quick checklist
- Are you accepting new patients?
- Do you accept my specific insurance plan?
- Do you provide the service I need at this address?
- Do I need a referral, and what is the earliest appointment?
Insurance participation and appointment availability are not established by these public records.
Medicare & insurance
Insurance participation is not established by these public records. Ask the practice and your insurer about your specific plan and this location.
How to check your coverage
Use your plan’s provider directory or the member-services number on your insurance card. Confirm the clinician, practice address, service, and whether a referral is required. A missing opt-out record does not establish Medicare acceptance.
Check the official Medicare directory ↗Practice location
12116 Se Mill Plain Blvd Ste 1Vancouver, WA 98684-6000
Education & affiliations
- Medical / professional school
- Pacific University - College Of Optometry
- Graduation year
- 2014
- CMS specialties
- Optometry
Graduation year does not establish years in practice. A reported affiliation does not establish employment, current admitting privileges, or insurance participation.
Source: CMS National Downloadable File · Published Oct 15, 2026.
Procedures in the public data
Reported activity can help you ask more informed questions about a practice’s services.
No displayed procedure-category record in this release. This does not mean the clinician performs no procedures.
CMS uses a one-year claims window with a reporting lag. Counts cover the Medicare activity included by CMS, not all patients. “1–10” is a published range. Volume is not a quality or outcomes score. Coverage and methodology
Source: CMS Utilization Data · Published Oct 15, 2026.
Service-mix comparison is unavailable for this NPI in the imported Medicare service file.
Industry-reported general payments
No matching general-payment summary in the imported release. This is not a verified zero and does not rule out other payment types or years.
Source: CMS 2025 payments grouped by covered recipient and nature of payments · Published Jun 30, 2026.
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Optometrist
- Taxonomy code
- 152W00000X
- Enumeration date
- Apr 22, 2013
- Record updated
- Oct 3, 2022
More registry details
- Provider type
- Individual · Type 1
Reported taxonomies and licenses
152W00000X
License reported: 3579ATI OR
390200000X
152W00000X · Primary
License reported: 60503088 WA
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
12116 Se Mill Plain Blvd Ste 1Vancouver, WA 98684-6000
- Phone
- (360) 719-1512
- Fax
- (503) 254-0576
Mailing address
5105 SW ELM AVEBEAVERTON, OR 970054230
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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