Healthcare Provider Details

I. General information

NPI: 1679487649
Provider Name (Legal Business Name): KRISZL MARIA PINEDA GODFREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17302 79TH DR NE
ARLINGTON WA
98223-9825
US

IV. Provider business mailing address

17302 79TH DR NE
ARLINGTON WA
98223-9825
US

V. Phone/Fax

Practice location:
  • Phone: 425-346-1665
  • Fax:
Mailing address:
  • Phone: 425-346-1665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60669286
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: