Individual provider Active NPI

Kristen Lyne Hursh, LMP

  • Specialist
  • Yakima, WA
National Provider Identifier
1124149521
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00015704 Issued in WA
Practice address
2501 Racquet LN
Yakima, WA 98902-6114
Phone
(509) 452-5155
Fax
(509) 452-5355
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00015704 WA Primary

Addresses

Primary practice location

2501 Racquet LN
Yakima, WA 98902-6114

Mailing address

260 Adobe Way
Selah, WA 98942-9081
Phone (509) 452-5155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00015704WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124149521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 ADOBE WAY",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989429081",
            "telephone_number": "509-452-5155",
            "fax_number": "509-452-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 RACQUET LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026114",
            "telephone_number": "509-452-5155",
            "fax_number": "509-452-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURSH",
        "first_name": "KRISTEN",
        "middle_name": "LYNE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00015704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.