Individual provider Active NPI

Sonja M. Krejci, MD

  • Dermatology Physician
  • Seattle, WA
National Provider Identifier
1588766620
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00033243 Issued in WA
Practice address
4740 44TH Ave SW
Suite 200
Seattle, WA 98116-4481
Phone
(206) 937-8954
Fax
(206) 937-1916
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00033243 WA Primary

Addresses

Primary practice location

4740 44TH Ave SW
Suite 200
Seattle, WA 98116-4481

Mailing address

4740 44TH Ave SW
Suite 200
Seattle, WA 98116-4481
Phone (206) 937-8954

Other identifiers 1

IdentifierTypeStateIssuer
8465429MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00033243WAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1588766620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 44TH AVE SW",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164481",
            "telephone_number": "206-937-8954",
            "fax_number": "206-937-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 44TH AVE SW",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164481",
            "telephone_number": "206-937-8954",
            "fax_number": "206-937-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREJCI",
        "first_name": "SONJA",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00033243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8465429",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.