Provider Demographics
NPI:1871665299
Name:LEE, KRISTEN A (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:A
Last Name:LEE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:A
Other - Last Name:SCHLEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:105 W 8TH AVE
Mailing Address - Street 2:SUITE 6010
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2341
Mailing Address - Country:US
Mailing Address - Phone:509-838-5950
Mailing Address - Fax:509-838-5961
Practice Address - Street 1:105 W 8TH AVE
Practice Address - Street 2:SUITE 6010
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2341
Practice Address - Country:US
Practice Address - Phone:509-838-5950
Practice Address - Fax:509-838-5961
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005184363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9628041Medicaid
WA9628041Medicaid
WA8805475Medicare ID - Type Unspecified