Provider Demographics
NPI:1033191531
Name:PILECKI, KRYSTYNA IZABELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:KRYSTYNA
Middle Name:IZABELLA
Last Name:PILECKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34036
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1036
Mailing Address - Country:US
Mailing Address - Phone:425-899-3292
Mailing Address - Fax:425-899-3269
Practice Address - Street 1:23929 MCBEAN PKWY STE 102
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4467
Practice Address - Country:US
Practice Address - Phone:425-883-3333
Practice Address - Fax:425-869-4854
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023585208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA010063771OtherMEDICARE RAILROAD
WA5621PIOtherBLUE SHIELD
WA8143083Medicaid
WA136718OtherLABOR & INDUSTRIES
WAG8883746Medicare PIN
WAG8890961Medicare PIN
WA5621PIOtherBLUE SHIELD
WAE21715Medicare UPIN
WAGAB14829Medicare PIN
WAG8897735Medicare PIN
WAG8878172Medicare PIN