Individual
KRISTA KAWAGUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 S 43RD ST, RENTON, WA 98055-5714
(425) 656-5566
(425) 656-5567
Mailing address
3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 98057-4970
(425) 690-2715
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD60299818
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018894
—
WA
01
—
G8944145
MEDICARE - VALLEY MEDICAL GROUP
WA
Enumeration date
04/02/2010
Last updated
03/10/2020
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