Provider Demographics
NPI:1649262122
Name:DOERR, KRISTEN K (ARNP)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:K
Last Name:DOERR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1887
Mailing Address - Street 2:CENTRAL WASHINGTON HOSPITAL FAMILY PHYSICIANS
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98807-1887
Mailing Address - Country:US
Mailing Address - Phone:509-665-6087
Mailing Address - Fax:509-665-6161
Practice Address - Street 1:1215 S MILLER ST
Practice Address - Street 2:CENTRAL WASHINGTON HOSPITAL FAMILY PHYSICIANS
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3201
Practice Address - Country:US
Practice Address - Phone:509-665-6087
Practice Address - Fax:509-665-6161
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP30007074363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8325086Medicaid
WA9646167Medicaid
WAP01408386OtherRR MEDICARE
WAG8856327Medicare PIN
WA8325086Medicaid
WAP01408386OtherRR MEDICARE