Provider Demographics
NPI:1083659262
Name:TARBET, KRISTIN J (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:J
Last Name:TARBET
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 2363
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-2363
Mailing Address - Country:US
Mailing Address - Phone:206-431-0138
Mailing Address - Fax:206-246-5819
Practice Address - Street 1:1810 116TH AVE NE STE D1
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3058
Practice Address - Country:US
Practice Address - Phone:425-455-2131
Practice Address - Fax:425-455-2335
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037309207W00000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3718TAOtherREGENCE
WA3718TAOtherREGENCE
WAG8859454Medicare PIN