Provider Demographics
NPI:1164129060
Name:HAYWARD, KRISTINA M
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:M
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 SW REDMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-8476
Mailing Address - Country:US
Mailing Address - Phone:503-852-7660
Mailing Address - Fax:
Practice Address - Street 1:310 E MAIN ST
Practice Address - Street 2:
Practice Address - City:YAMHILL
Practice Address - State:OR
Practice Address - Zip Code:97148-8641
Practice Address - Country:US
Practice Address - Phone:503-852-7660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool