Provider Demographics
NPI:1932499951
Name:SOBKOWIAK, KRISTEN LYNN (MA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LYNN
Last Name:SOBKOWIAK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:LYNN
Other - Last Name:BURK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5904 W ARMSTRONG DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-4947
Mailing Address - Country:US
Mailing Address - Phone:509-263-9709
Mailing Address - Fax:
Practice Address - Street 1:124 E AUGUSTA AVE
Practice Address - Street 2:STE 100
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2481
Practice Address - Country:US
Practice Address - Phone:509-325-0777
Practice Address - Fax:509-325-3464
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60148851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health