Chastity Kribble
Individual provider Active NPI Specialist · MLT, WA
NPI 1003299769 · NPPES record last updated Jun 30, 2015
Key facts
- NPI
- 1003299769
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MA60443424 (WA)
- Practice address
- 22002 64TH Ave W
Suite M11A
MLT, WA 98043 - Phone
- (206) 818-0028
- Fax
- (425) 984-0112
- NPI assigned
- Jun 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60443424 | WA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA60443424 | WA | Yes |
Addresses
Primary practice location
22002 64TH Ave W
Suite M11A
MLT, WA 98043
Mailing address
18705 126TH Ave NE Apt 2721
Bothell, WA 98011-9349
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.