Healthcare Provider Details

I. General information

NPI: 1467384933
Provider Name (Legal Business Name): KRISTIN LAVERGNE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN SANKWICH PHARMD

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 116TH AVE NE
BELLEVUE WA
98004-4604
US

IV. Provider business mailing address

4139 97TH AVE SE
MERCER ISLAND WA
98040-4237
US

V. Phone/Fax

Practice location:
  • Phone: 425-688-5000
  • Fax:
Mailing address:
  • Phone: 425-894-9448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0020572
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH.60526858
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: