Provider Demographics
NPI:1003364258
Name:MYHRES, KIRSTEN (MS)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:MYHRES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:
Other - Last Name:LIVINGSTONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:12333 NE 130TH LN
Mailing Address - Street 2:TAN 240
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7467
Mailing Address - Country:US
Mailing Address - Phone:425-899-2221
Mailing Address - Fax:425-899-2210
Practice Address - Street 1:12333 NE 130TH LN
Practice Address - Street 2:TAN 240
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7467
Practice Address - Country:US
Practice Address - Phone:425-899-2221
Practice Address - Fax:425-899-2210
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAGT 60550854170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS