Basic Information
| Provider Information | |||||||||
| NPI: | 1740832955 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICHARDS | ||||||||
| FirstName: | KRISTYNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1811 156TH AVE NE STE 2 | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980074344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254607125 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1811 156TH AVE NE STE 2 | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980074344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254607125 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2019 | ||||||||
| LastUpdateDate: | 11/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | CG60983577 | WA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.