Provider Demographics
NPI:1487096178
Name:ROUSE, KRISTOFFER JOHN ALMAZAN (PHD, MA, LMHC)
Entity type:Individual
Prefix:DR
First Name:KRISTOFFER
Middle Name:JOHN ALMAZAN
Last Name:ROUSE
Suffix:
Gender:M
Credentials:PHD, MA, LMHC
Other - Prefix:DR
Other - First Name:KRISTOFFER
Other - Middle Name:JOHN ALMAZAN
Other - Last Name:ROUSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:1700 NW GILMAN BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5364
Mailing Address - Country:US
Mailing Address - Phone:206-496-6109
Mailing Address - Fax:425-295-7637
Practice Address - Street 1:1700 NW GILMAN BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5364
Practice Address - Country:US
Practice Address - Phone:206-496-6109
Practice Address - Fax:425-295-7637
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60560653101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health