Marta Lee Krissovich, ANP-BC, CWOCN-AP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

N260535011 Issued in WA

Practice address

151 Sunset Blvd
Port Townsend, WA 98368-8913

Phone

(360) 316-6306

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Marta L. Patmas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1710045778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SUNSET BLVD",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983688913",
            "telephone_number": "360-316-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SUNSET BLVD",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983688913",
            "telephone_number": "360-316-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISSOVICH",
        "first_name": "MARTA",
        "middle_name": "LEE",
        "credential": "ANP-BC, CWOCN-AP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "N260535011",
            "primary": true
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "WA",
            "license": "RN60533319",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED REGISTERED NURSE PRACTITIONER LICENSE",
            "identifier": "N260535011",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED FOOT CARE NURSE (CFCN) BY WOCNCB",
            "identifier": "2005458420",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "RN60533319",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED WOUND, OSTOMY & CONTINENCE CARE NURSE-ADV. PRACTICE (CWOCN-AP), WOCNCB",
            "identifier": "2013652089",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED GERONTOLOGICAL NURSE (RN-BC), ANCC",
            "identifier": "2011014922",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT NURSE PRACTITIONER-BOARD CERTIFIED (ANP-BC) BY ANCC",
            "identifier": "2008007311",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTA",
            "last_name": "PATMAS",
            "middle_name": "L.",
            "credential": "RN, MSN, CCCN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynthia Koan
• Glen Wayne Koch, LMT
• Anne Elizabeth Koomen, ARNP
• Joshua Kraetsch, LMHC
• Mary Beth Krehbiel
• Vanessa D Kroger, MA
• Dimitri D Kuznetsov, MD
• L'Chaim LLC
• Peter Paul Lack
• Robert Laitman

• Adult Health Nurse Practitioner in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Adult Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.