Provider Demographics
NPI:1386627545
Name:MCKINNEY, KRISTI KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:KAY
Last Name:MCKINNEY
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 1:11203 BRIDGEPORT WAY SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3002
Mailing Address - Country:US
Mailing Address - Phone:253-589-1380
Mailing Address - Fax:253-589-1786
Practice Address - Street 1:11203 BRIDGEPORT WAY SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499
Practice Address - Country:US
Practice Address - Phone:253-589-1380
Practice Address - Fax:253-589-1786
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE85420208000000X
WAMD60273895207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics