Provider Demographics
NPI:1912128711
Name:ROYAL, KRISTEN L (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:ROYAL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:L
Other - Last Name:HOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2704 I ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-2411
Mailing Address - Country:US
Mailing Address - Phone:253-833-7444
Mailing Address - Fax:253-735-4111
Practice Address - Street 1:33301 1ST WAY S
Practice Address - Street 2:STE C-115
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6252
Practice Address - Country:US
Practice Address - Phone:253-661-6634
Practice Address - Fax:253-735-4111
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002461106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist