Kelly Kristin Gaudreau, RN

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L-157390 Issued in WA

Practice address

751 NE Blakely Dr
Issaquah, WA 98029-6201

Phone

(425) 313-2377

NPI assigned

Jan 25, 2023

Last updated

Jan 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1063128866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-313-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-313-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUDREAU",
        "first_name": "KELLY",
        "middle_name": "KRISTIN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "WA",
            "license": "L-157390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Garrido, ARNP
• Benedict Garry, MD
• Gary Folkman DDS
• Isabella Victoria Garza, OTD
• Sarah Delaney Gaston
• Chelsea Gault, LICSW
• Heloise Gayet
• Rebecca Ann Gentile
• Kara Gerhart, CNM, DNP
• Erin Gesing

• Lactation Consultant (Registered Nurse) in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Lactation Consultant (Registered Nurse) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.