Provider Demographics
NPI:1619133998
Name:LAVIN, KRISTINE LEHUA (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:LEHUA
Last Name:LAVIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2475 140TH AVE NE BLDG C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1892
Mailing Address - Country:US
Mailing Address - Phone:424-460-5600
Mailing Address - Fax:
Practice Address - Street 1:2475 140TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1892
Practice Address - Country:US
Practice Address - Phone:425-460-5601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60021584363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics