Individual provider Active NPI

Krista L Gibbons, MC60701062

  • Counselor
  • Issaquah, WA
National Provider Identifier
1942751771
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1700 NW Blvd
Suite #200
Issaquah, WA 98027
Phone
(425) 295-7697
NPI assigned
Oct 17, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Counselor 101Y00000X MC60701062 WA

Addresses

Primary practice location

1700 NW Blvd
Suite #200
Issaquah, WA 98027

Mailing address

1700 NW Gilman Blvd Ste 200
Issaquah, WA 98027-5364
Phone (425) 295-7697

Other practice location 1

811 Madison St
Sunrise Services Inc.
Everett, WA 98203-4543
Phone (425) 212-4200

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MC60701062WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942751771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW GILMAN BLVD STE 200",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275364",
            "telephone_number": "425-295-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW BLVD",
            "address_2": "SUITE #200",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98027",
            "telephone_number": "425-295-7697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 Madison St",
            "address_2": "Sunrise Services Inc.",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982034543",
            "country_code": "US",
            "telephone_number": "425-212-4200",
            "fax_number": "425-212-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "KRISTA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MC60701062",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC60701062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.