Provider Demographics
NPI:1609954585
Name:MORRIS, KRISTI K (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:K
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ORONDO AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2800
Mailing Address - Country:US
Mailing Address - Phone:509-662-6000
Mailing Address - Fax:509-664-4590
Practice Address - Street 1:500 KIRTS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4140
Practice Address - Country:US
Practice Address - Phone:248-824-6060
Practice Address - Fax:248-686-0772
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005245363AM0700X
MI5601009932363AM0700X
CAPA21461363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3451MOOtherBSWA
WA0229012OtherLIWA
WA1092255Medicaid
TX8G9906Medicare ID - Type Unspecified
TX8G9907Medicare ID - Type Unspecified
WA1092255Medicaid
WAG8867958Medicare PIN
WA3451MOOtherBSWA
WAG8867957Medicare PIN
WAG8868788Medicare PIN
WA0224791OtherL & I
TX183209904Medicaid
WA0225882OtherLIWA
WAG8867957Medicare PIN
WAG8868788Medicare PIN