Provider Demographics
NPI:1184387888
Name:BRASHEAR, KRISTEN MICHELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:BRASHEAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:MICHELLE
Other - Last Name:BAUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9806 59TH DR NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-2413
Mailing Address - Country:US
Mailing Address - Phone:425-750-0922
Mailing Address - Fax:
Practice Address - Street 1:9806 59TH DR NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-2413
Practice Address - Country:US
Practice Address - Phone:425-750-0922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61204939101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health