Provider Demographics
NPI:1730321290
Name:ROGERS, KRISTIN (LM, CPM)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14621 NE 31ST ST
Mailing Address - Street 2:#11A
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3658
Mailing Address - Country:US
Mailing Address - Phone:206-719-5029
Mailing Address - Fax:
Practice Address - Street 1:14621 NE 31ST ST
Practice Address - Street 2:#11A
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3658
Practice Address - Country:US
Practice Address - Phone:206-719-5029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60057957176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife