Basic Information
| Provider Information | |||||||||
| NPI: | 1831451061 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIVINGSTON | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | JEANNE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2975 MARTINSSON LN S | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973026019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302270132 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5125 SKYLINE RD S | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973069427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038132000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2012 | ||||||||
| LastUpdateDate: | 02/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/11/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 192885 | OR | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 49412 | AZ | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 15432 | NV | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | A119369 | CA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.