Individual provider Active NPI

Kathryn Hryniewicz

  • Pediatrics Physician
  • Pullman, WA
National Provider Identifier
1669748604
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60577173 Issued in WA
Practice address
1205 SE Professional Mall Blvd Ste 104
Pullman, WA 99163-5423
Phone
(509) 332-2605
NPI assigned
Mar 23, 2012
Last updated
Jul 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ML60292823 WA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD60577173 WA Primary

Addresses

Primary practice location

1205 SE Professional Mall Blvd Ste 104
Pullman, WA 99163-5423

Mailing address

4800 Sand Point Way NE
A-5850
Seattle, WA 98105-2864

Other practice location 1

4800 Sand Point Way NE
A-5950
Seattle, WA 98105-3901
Phone (206) 987-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171027001620 ID Practitioner - Pediatric Medicine 8921374497 Reassigns benefits to 1 organization
I20240105003325 WA Practitioner - Pediatric Medicine 8921374497 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ML60292823WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County CurrentSince Nov 20, 2023 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients
Public Hospital District # 1-a Past Accepting new patients

Locations

1420 S Blaine St
Ste 5
Moscow, ID 83843
Phone (208) 882-2247

2500 W A St
Ste 201
Moscow, ID 83843
Phone (208) 332-2828

1205 SE Professional Mall Blvd
Ste 104
Pullman, WA 99163
Phone (509) 332-2605

825 SE Bishop Blvd
Ste 201
Pullman, WA 99163
Phone (509) 336-7577

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

840 SE Bishop Blvd
Ste 101
Pullman, WA 99163
Phone (509) 332-6139

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1669748604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "A-5850",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981052864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SE PROFESSIONAL MALL BLVD STE 104",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-332-2605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE",
            "address_2": "A-5950",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HRYNIEWICZ",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML60292823",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60577173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.