Provider Demographics
NPI:1073027942
Name:BYRNES, KRYSTA ROSE CARRICK (RN)
Entity Type:Individual
Prefix:MS
First Name:KRYSTA
Middle Name:ROSE CARRICK
Last Name:BYRNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:KRYSTA
Other - Middle Name:ROSE
Other - Last Name:CARICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2505 2ND AVE STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1495
Practice Address - Country:US
Practice Address - Phone:206-520-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK147512163W00000X
WARN60378121163WP0807X, 163WP0809X, 163WW0101X
WAAP61052022363L00000X, 363LF0000X
AK147513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner