Provider Demographics
NPI:1114905007
Name:KROL, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:KROL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4748
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID123432085R0202X
WAMD000435432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1114905007Medicaid
WA0187098OtherL&I-EVERGREEN RADIA
WA0381107OtherL&I-RADIA SEATTLE COUNTY
WA0385164OtherL&I-SOUTH SOUND RADIOLOGY
WA8397887Medicaid
WA0187099OtherL&I-RADIA REST OF WA
WA0381109OtherL&I-SWEDISH RADIA EDMONDS
ID1114905007Medicaid
WA8397887Medicaid
WAP00147765Medicare PIN
WA187099OtherPROVIDER NUMBER L&I
ID20005582Medicare PIN
WA8862966Medicare PIN
WAP00335957Medicare PIN
WAG8803441Medicare PIN
WA187097OtherPROVIDER NUMBER L&I
WAG8803447Medicare PIN