Basic Information
| Provider Information | |||||||||
| NPI: | 1396882106 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VENTURINI | ||||||||
| FirstName: | CHRYSTEL | ||||||||
| MiddleName: | THERESE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| 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: | 3417 ENSIGN RD NE | ||||||||
| Address2: | |||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985065064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604934600 | ||||||||
| FaxNumber: | 3604934603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 02/14/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MD00040907 | WA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 000000697063 | 01 | KY | ANTHEM- KENTUCKY CHILDREN'S RADIOLOGISTS | OTHER | 0379437 | 01 | WA | L&I-SOUTH SOUND RADIOLOGY | OTHER | 122797 | 01 | KY | SIHO- KENTUCKY CHILDREN'S RADIOLOGISTS | OTHER | 000057094W | 01 | KY | HUMANA- KENTUCKY CHILDREN'S RADIOLOGISTS | OTHER | 0384449 | 01 | WA | L&I-RADIA | OTHER | 2008419 | 05 | WA | MEDICAID | 7100170330 | 05 | KY | MEDICAID | 201018220 | 05 | IN | MEDICAID |