Provider Demographics
NPI:1639352560
Name:LINSENMAYER, KRISTI A (DDS MPH MSD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:A
Last Name:LINSENMAYER
Suffix:
Gender:F
Credentials:DDS MPH MSD
Other - Prefix:DR
Other - First Name:KRISTI
Other - Middle Name:
Other - Last Name:LINSENMAYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MPH MSD
Mailing Address - Street 1:PO BOX 3364
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98114-3364
Mailing Address - Country:US
Mailing Address - Phone:206-324-9360
Mailing Address - Fax:206-324-8910
Practice Address - Street 1:611 12TH AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-1910
Practice Address - Country:US
Practice Address - Phone:206-324-9360
Practice Address - Fax:206-324-8910
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00007075122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE00007075OtherLICENSE NUMBER
WA5017983Medicaid
WA5017983Medicaid