Basic Information
Provider Information
NPI: 1891806865
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRIEG
FirstName: MARGARET
MiddleName: MARY
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2512 WHEATON WAY STE A
Address2:  
City: BREMERTON
State: WA
PostalCode: 983103303
CountryCode: US
TelephoneNumber: 3607825700
FaxNumber: 2534266344
Practice Location
Address1: 2512 WHEATON WAY STE A
Address2:  
City: BREMERTON
State: WA
PostalCode: 983103303
CountryCode: US
TelephoneNumber: 3607825700
FaxNumber: 2534266344
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 12/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X28801WAN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RP1001XMD00028801WAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

ID Information
IDTypeStateIssuerDescription
105587705WA MEDICAID


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