Basic Information
Provider Information
NPI: 1881793842
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAYWARD
FirstName: KRISTEN
MiddleName: NICOLE
NamePrefix:  
NameSuffix:  
Credential: MD, MS
OtherOrganizationName:  
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Mailing Information
Address1: 4800 SAND POINT WAY NE
Address2: M/S R-5420
City: SEATTLE
State: WA
PostalCode: 981053901
CountryCode: US
TelephoneNumber: 2069872057
FaxNumber: 2069875060
Practice Location
Address1: 4800 SAND POINT WAY NE
Address2: M/S R-5420
City: SEATTLE
State: WA
PostalCode: 981053901
CountryCode: US
TelephoneNumber: 2069872057
FaxNumber: 2069875060
Other Information
ProviderEnumerationDate: 09/22/2006
LastUpdateDate: 01/12/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0216XMD00043647WAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology

No ID Information.


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