Active NPI
Kristian L Stewart, CDPT
- Counselor
- Sunnyside, WA
National Provider Identifier
1235367830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60164123
- Practice address
- 702 East Franklin Avenue
Sunnyside, WA 98944-9744 - Phone
- (509) 575-4084
- NPI assigned
- Jun 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | RC60101814 | WA | |
| Counselor | 101Y00000X | CG60164123 | WA | Primary |
| Case Manager/Care Coordinator | 171M00000X | WA |
Addresses
Primary practice location
702 East Franklin Avenue
Sunnyside, WA 98944-9744
Mailing address
420 S 34TH Ave
Yakima, WA 98902-3641
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
| License | State | Type | Specialty |
|---|---|---|---|
| CG60164123 | WA | MD | Counselor |
| RC60101814 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336608000000",
"number": "1235367830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 S 34TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 EAST FRANKLIN AVENUE",
"city": "SUNNYSIDE",
"state": "WA",
"postal_code": "989449744",
"telephone_number": "509-575-4084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "KRISTIAN",
"middle_name": "L",
"credential": "CDPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-23",
"last_updated": "2012-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "RC60101814",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60164123",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "WA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyside, WA
- Matthew Thomas Smith, RPH
- Spavinawdental
- Amy Patricia Sprague, LMP
- Marie Teresa Stanford, MD
- James E Stevens, DR MEDICAL DENTISTRY
- Carla Sue Stoops, COTA/L
- Demetrius Straws
- Sunnyside Chiropractic Centre P S
- Sunnyside Community Hospital
- Sunnyside Community Hospital (Sunnyside ENT, Sunnyside Bone and Joint)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.