Individual
KRISTIE MICHELLE MATTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
7902 27TH ST W STE 7A, UNIVERSITY PLACE, WA 98466-3431
(253) 500-4059
(253) 503-7977
Mailing address
7902 27TH ST W STE 7A, UNIVERSITY PLACE, WA 98466-3431
(253) 346-8859
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003450
WA
363AS0400X
Surgical Physician Assistant
PA10003450
WA
Other
Enumeration date
10/03/2011
Last updated
06/20/2022
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