Provider Demographics
NPI:1033109855
Name:KRAFT, DENISE S (MD)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:S
Last Name:KRAFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1200 112TH AVE NE
Mailing Address - Street 2:STE C160
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3732
Mailing Address - Country:US
Mailing Address - Phone:425-453-1039
Mailing Address - Fax:425-453-8955
Practice Address - Street 1:1200 112TH AVE NE
Practice Address - Street 2:STE C160
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3732
Practice Address - Country:US
Practice Address - Phone:425-453-1039
Practice Address - Fax:425-453-8955
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2008-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00018535207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8326001Medicaid
A04927Medicare UPIN