Provider Demographics
NPI:1487671434
Name:KRISTIN J TARBET MD PLLC
Entity Type:Organization
Organization Name:KRISTIN J TARBET MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TARBET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-455-2131
Mailing Address - Street 1:PO BOX 69737
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-8737
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037309207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3718TAOtherBCBS GROUP #
WAG8859453Medicare PIN