Provider Demographics
NPI:1548735897
Name:HILLS, KRIS GLEN
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:GLEN
Last Name:HILLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 S BRANDON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98134-2428
Mailing Address - Country:US
Mailing Address - Phone:206-467-7550
Mailing Address - Fax:
Practice Address - Street 1:28 S BRANDON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2428
Practice Address - Country:US
Practice Address - Phone:206-467-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60142491175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist