Provider Demographics
NPI:1578813465
Name:ORLOWSKI, KRISSA JO (PA)
Entity Type:Individual
Prefix:
First Name:KRISSA
Middle Name:JO
Last Name:ORLOWSKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KRISSA
Other - Middle Name:JO
Other - Last Name:HIPWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:253-370-0293
Mailing Address - Fax:253-353-7650
Practice Address - Street 1:11019 CANYON RD E
Practice Address - Street 2:SUITE A
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-4298
Practice Address - Country:US
Practice Address - Phone:253-537-0293
Practice Address - Fax:253-537-7650
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60310468363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical