Provider Demographics
NPI:1710289202
Name:JONES, KRISTEN RENEA GOETZ (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RENEA GOETZ
Last Name:JONES
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 1:4802 S 215TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-8481
Mailing Address - Country:US
Mailing Address - Phone:206-321-6935
Mailing Address - Fax:
Practice Address - Street 1:4802 S 215TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-8481
Practice Address - Country:US
Practice Address - Phone:206-321-6935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60159381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily