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Individual

MELANIE KRISTOFERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
3639 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144
(206) 695-7604
Mailing address
3639 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144-6847

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60557169
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60884302
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN60557169
RN
WA
Enumeration date
09/25/2015
Last updated
07/26/2019
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