Provider Demographics
NPI:1518161017
Name:SPINNING, KRISTOPHER ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:ADAM
Last Name:SPINNING
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:2007-06-11
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-123222085P0229X, 2085R0202X
WAMD602929052085R0202X, 2085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA310095OtherL&I PROVIDER ID
ID1518161017Medicaid
WA2022999Medicaid
WA310098OtherL&I PROVIDER ID
WA310093OtherL&I PROVIDER ID
WA377863OtherL&I PROVIDER ID
WAG8912158Medicare PIN
WAG8912157Medicare PIN
ID20004830Medicare PIN
WAG8912160Medicare PIN
ID1518161017Medicaid
WA2022999Medicaid