Organization
KRISTIE MATTERN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIE MATTERN PA (OWNER/PROVIDER)
(253) 973-6135
Entity
Organization
Contact information
Practice address
7902 27TH ST W STE 7A, UNIVERSITY PLACE, WA 98466-3431
(253) 500-4059
Mailing address
7902 27TH ST W STE 7A, UNIVERSITY PLACE, WA 98466-3431
(253) 500-4059
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023392529
NPI
WA
Enumeration date
08/16/2022
Last updated
08/16/2022
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