Kristopher Charles Lee Wannquist

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61645789 Issued in WA

Practice address

4526 Federal Ave # Ms 11
Everett, WA 98203-2132

Phone

(425) 349-6200

NPI assigned

Jul 12, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1295469658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE # MS 11",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE # MS 11",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANNQUIST",
        "first_name": "KRISTOPHER",
        "middle_name": "CHARLES LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-12",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61645789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wei Wang
• Xiaowen Wang, MD
• Yudi Wang, MS, MED
• Joshua L Wangadi, PHARMD
• Ann M Wanner, MD
• Ashley Warcola, PHARMD
• Alissa Ward
• Baleva Maurice Ward, CDP, CV
• Judy W Ward, RN
• Patricia Ward, RN

• Mental Health Counselor in Everett, WA
• Providers in Everett, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.