Individual provider Active NPI

Kirkland Devers, OD

  • Optometrist
  • Arlington, WA
National Provider Identifier
1174242879
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61435299 Issued in WA
Practice address
4011 172ND St NE
Arlington, WA 98223-7355
Phone
(360) 454-1936
Fax
(360) 454-1991
NPI assigned
Aug 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61435299 WA Primary

Addresses

Primary practice location

4011 172ND St NE
Arlington, WA 98223-7355

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027000770 WA Practitioner - Optometry 0941656953 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

4011 172ND St NE
Arlington, WA 98223-8482
Phone (425) 259-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD61435299WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Wave Eye Doctors Professional Limited Liability Company Optometrist CurrentSince Oct 2, 2023 Accepting new patients
The Polyclinic PLLC CurrentSince Jan 16, 2025 Accepting new patients
Blue Wave Eye Doctors Professional Limited Liability Company CurrentSince Oct 2, 2023 Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 16, 2025 Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 16, 2025 Accepting new patients
The Polyclinic PLLC Current Accepting new patients
The Polyclinic CurrentSince Jan 16, 2025 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
The Polyclinic PLLC Past Accepting new patients
Omni Eye Specialists P a PastSince Aug 1, 2022 Accepting new patients

Locations

4011 172nd St NE
Arlington, WA 98223
Phone (360) 454-1936

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

305 SE Everett Mall Way
Ste 21
Everett, WA 98208
Phone (425) 267-0575

921 N 10th St
Ste B
Renton, WA 98057
Phone (425) 255-1022

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kdevers93899@direct.tecmc.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1174242879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 172ND ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237355",
            "telephone_number": "360-454-1936",
            "fax_number": "360-454-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERS",
        "first_name": "KIRKLAND",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61435299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

Verify at the official NPI Registry.