Provider Demographics
NPI:1033650700
Name:O'LEARY, KRISTEN MICHELLE (DC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:O'LEARY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 EASTSIDE DRIVE NE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422
Mailing Address - Country:US
Mailing Address - Phone:510-600-8223
Mailing Address - Fax:
Practice Address - Street 1:6720 EASTSIDE DRIVE NE
Practice Address - Street 2:SUITE 2
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422
Practice Address - Country:US
Practice Address - Phone:510-600-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program