Active NPI
Kris Kyro PH.D. Inc. P.S.
- Clinical Psychologist
- Everett, WA
National Provider Identifier
1477565620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1477
- Legal business name
- KRIS KYRO PH.D. INC. P.S.
- Practice address
- 3206 Wetmore Ave
Suite 13
Everett, WA 98201-6407 - Phone
- (425) 258-2958
- Fax
- (425) 259-0861
- NPI assigned
- Aug 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kristopher J Kyro, PH.D
- Title
- Owner
- Phone
- (425) 258-2958
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1477 | WA | Primary |
Addresses
Primary practice location
3206 Wetmore Ave
Suite 13
Everett, WA 98201-6407
Mailing address
3206 Wetmore Ave
Suite 13
Everett, WA 98201-6407
Phone (425) 258-2958
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0165866 | Other | WA | LABOR AND INDUSTRIES |
| 7815223 | Other | AETNA | |
| 192504 | Other | VALUE OPTIONS | |
| 7300494 | Medicaid | WA | |
| 8852KY | Other | REGENCE |
National Provider Directory
National Provider DirectoryLocations
3206 Wetmore Ave
Unit 13
Everett, WA 98201
Phone (425) 258-2958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1477565620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3206 WETMORE AVE",
"address_2": "SUITE 13",
"city": "EVERETT",
"state": "WA",
"postal_code": "982016407",
"telephone_number": "425-258-2958",
"fax_number": "425-259-0861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3206 WETMORE AVE",
"address_2": "SUITE 13",
"city": "EVERETT",
"state": "WA",
"postal_code": "982016407",
"telephone_number": "425-258-2958",
"fax_number": "425-259-0861"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KRIS KYRO PH.D. INC. P.S.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KYRO",
"authorized_official_first_name": "KRISTOPHER",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "425-258-2958",
"authorized_official_credential": "PH.D"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "1477",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0165866",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7815223",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "192504",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7300494",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "8852KY",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.