Active NPI
Kristine Marie Proctor, LMP,MMP
- Specialist
- Kent, WA
National Provider Identifier
1588715957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00018749
- Practice address
- 13210 SE 240TH St
Suite a-4
Kent, WA 98042-5182 - Phone
- (253) 631-1118
- NPI assigned
- Jan 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00018749 | WA | Primary |
Addresses
Primary practice location
13210 SE 240TH St
Suite a-4
Kent, WA 98042-5182
Mailing address
17118 SE 181St PL
Renton, WA 98058-8759
Phone (425) 830-8308
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0182527 | Other | WA | LABOR AND INDUSTRIES |
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 |
|---|---|---|---|
| MA00018749 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Valley Chiropractic Clinic, PS | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Kent, WA
- NPI 1245377241
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588715957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17118 SE 181ST PL",
"city": "RENTON",
"state": "WA",
"postal_code": "980588759",
"telephone_number": "425-830-8308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13210 SE 240TH ST",
"address_2": "SUITE A-4",
"city": "KENT",
"state": "WA",
"postal_code": "980425182",
"telephone_number": "253-631-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "KRISTINE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LMP,MMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00018749",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0182527",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
- Tiana Leah Price, RN
- Prime Dental Group, LLC
- Vonda K Prioleau, LMP
- Pristine House LLC (Pristine House)
- Pro Med Alliance Medical Staffing
- Proliance Surgeons Inc., P.S. (STAR Sports Therapy and Athletic Rehabilitation)
- Proliance Surgeons, Inc., P.S. (Proliance Orthopedic Associates MRI)
- Jennifer Brooke Prudhomme, CPM-TN
- Public Hospital District #1 of King County (VMC Kent Primary Care)
- Raychel Puga Reynoso
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.