Basic Information
Provider Information
NPI: 1114905007
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KROL
FirstName: CHRISTOPHER
MiddleName: M.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19020 33RD AVE W STE 210
Address2:  
City: LYNNWOOD
State: WA
PostalCode: 980364748
CountryCode: US
TelephoneNumber: 4255631500
FaxNumber: 4255631374
Practice Location
Address1: 19020 33RD AVE W STE 210
Address2:  
City: LYNNWOOD
State: WA
PostalCode: 980364748
CountryCode: US
TelephoneNumber: 4255631500
FaxNumber: 4255631501
Other Information
ProviderEnumerationDate: 01/03/2006
LastUpdateDate: 04/17/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X12343IDN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XMD00043543WAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
111490500705ID MEDICAID
018709801WAL&I-EVERGREEN RADIAOTHER
038110701WAL&I-RADIA SEATTLE COUNTYOTHER
038516401WAL&I-SOUTH SOUND RADIOLOGYOTHER
839788705WA MEDICAID
018709901WAL&I-RADIA REST OF WAOTHER
038110901WAL&I-SWEDISH RADIA EDMONDSOTHER


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