Krysteia Hake, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

60004963 Issued in WA

Practice address

615 8TH St
Hoquiam, WA 98550-3522

Phone

(360) 532-4357

Fax

(360) 538-0124

NPI assigned

Jul 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Krysteia Hake-Purdum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1811474331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322316",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 8TH ST",
            "city": "HOQUIAM",
            "state": "WA",
            "postal_code": "985503522",
            "telephone_number": "360-532-4357",
            "fax_number": "360-538-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKE",
        "first_name": "KRYSTEIA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "60004963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTEIA",
            "last_name": "HAKE-PURDUM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grays Harbor Community Hospital
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• Gregory Alan Grun, RPH
• Kelly S Haggerty, RN
• Monica Hallak, ARNP
• Nicholas Hallak, MD
• Donna Rae Hallock
• Aaron Paul Hamm
• Tessa Lynn Hammond, RN

• All providers in Hoquiam, WA
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.