Provider Demographics
NPI:1134572142
Name:ROY, KRISTINE (CHHC)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 MAPLELEAF RD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-6851
Mailing Address - Country:US
Mailing Address - Phone:503-636-0266
Mailing Address - Fax:
Practice Address - Street 1:11560 SW 67TH AVE STE 207
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-9636
Practice Address - Country:US
Practice Address - Phone:503-384-8373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator