Provider Demographics
NPI:1790936748
Name:HOUGH, KRISTA NICOLE (CPHT)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:NICOLE
Last Name:HOUGH
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6619 132ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8627
Mailing Address - Country:US
Mailing Address - Phone:425-881-5544
Mailing Address - Fax:425-869-2227
Practice Address - Street 1:6619 132ND AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8627
Practice Address - Country:US
Practice Address - Phone:425-881-5544
Practice Address - Fax:425-869-2227
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA60041778183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician