Provider Demographics
NPI:1548838691
Name:KRUIDENIER, LUKAS DANIEL (MS, GC)
Entity type:Individual
Prefix:
First Name:LUKAS
Middle Name:DANIEL
Last Name:KRUIDENIER
Suffix:
Gender:M
Credentials:MS, GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 4TH AVE APT 219
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2051
Mailing Address - Country:US
Mailing Address - Phone:970-590-7119
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:970-590-7119
Practice Address - Fax:206-987-2495
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS