Kris Colletto, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00039202 Issued in WA

Practice address

3400 Main St
Vancouver, WA 98663-2223

Phone

(360) 696-5232

Fax

(360) 696-5228

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcolletto540170@direct.peacehealth.org

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.

• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Multicare Health System

  dba MultiCare Immediate Clinic

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1396297487
  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1629129523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34584",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241584",
            "telephone_number": "509-241-7349",
            "fax_number": "509-241-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632223",
            "telephone_number": "360-696-5232",
            "fax_number": "360-696-5228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16811 SE McGillivray Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986833404",
            "country_code": "US",
            "telephone_number": "360-735-8100",
            "fax_number": "360-253-1781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 NE 87th Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986641965",
            "country_code": "US",
            "telephone_number": "360-514-6450",
            "fax_number": "360-514-6451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3240 NE 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Camas",
            "state": "WA",
            "postal_code": "986072408",
            "country_code": "US",
            "telephone_number": "360-729-8234",
            "fax_number": "360-729-3337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 NE 192nd Avenue, Suite 310",
            "address_purpose": "LOCATION",
            "city": "camas",
            "state": "WA",
            "postal_code": "98607",
            "country_code": "US",
            "telephone_number": "360-729-8200",
            "fax_number": "360-729-8201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10516 Silverdale Way NW Ste 104",
            "address_purpose": "LOCATION",
            "city": "Silverdale",
            "state": "WA",
            "postal_code": "983838745",
            "country_code": "US",
            "telephone_number": "360-692-3950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLETTO",
        "first_name": "KRIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WA",
            "license": "MD00039202",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "BC5836032",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00039202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8269276",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Aaron Coleman, DO
• Ryan Colin
• Leslie Ann Colip, M.D.
• Irene Monica Collazo, MSW
• Barbara Jean Colleran, RN
• Joshua D Colley, PA-C
• Andrea Collier, LMP
• Savannah Collier, MD
• Tim R Collier, RN
• Judy Lee Colligan-Marshall, PMHNP

• Internal Medicine Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.