Provider Demographics
NPI:1922513076
Name:PTASINSKI, KRYSTINA (CDP)
Entity Type:Individual
Prefix:
First Name:KRYSTINA
Middle Name:
Last Name:PTASINSKI
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N 36TH ST STE 415
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8699
Mailing Address - Country:US
Mailing Address - Phone:206-395-9081
Mailing Address - Fax:
Practice Address - Street 1:600 N 36TH ST STE 415
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8699
Practice Address - Country:US
Practice Address - Phone:206-395-9081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-12
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60905969101YA0400X
WALH6091224101YM0800X
WACO60650873171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACO60650873OtherSTATE LICENSE