Healthcare Provider Details

I. General information

NPI: 1447618764
Provider Name (Legal Business Name): KRISTAL J MARTIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 NE OLD BELFAIR HWY
BELFAIR WA
98528-9637
US

IV. Provider business mailing address

PO BOX 277
BELFAIR WA
98528-0277
US

V. Phone/Fax

Practice location:
  • Phone: 360-275-6711
  • Fax: 360-275-6224
Mailing address:
  • Phone: 360-275-6711
  • Fax: 360-275-6224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60949923
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: