Provider Demographics
NPI:1568726479
Name:HUBBARD, KERSTEN ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KERSTEN
Middle Name:ANN
Last Name:HUBBARD
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 1:18000 INTERNATIONAL BLVD
Mailing Address - Street 2:#950
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-4253
Mailing Address - Country:US
Mailing Address - Phone:206-878-1985
Mailing Address - Fax:206-878-1539
Practice Address - Street 1:18000 INTERNATIONAL BLVD
Practice Address - Street 2:#950
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-4253
Practice Address - Country:US
Practice Address - Phone:206-878-1985
Practice Address - Fax:206-878-1539
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00034080207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine