Healthcare Provider Details

I. General information

NPI: 1497472500
Provider Name (Legal Business Name): KATHERINE ANNE CRISTIANO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 10/20/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 116TH AVE NE
BELLEVUE WA
98004-3016
US

IV. Provider business mailing address

2100 116TH AVE NE
BELLEVUE WA
98004-3016
US

V. Phone/Fax

Practice location:
  • Phone: 425-453-0766
  • Fax: 425-451-3560
Mailing address:
  • Phone: 425-453-0766
  • Fax: 425-451-3560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP61351352
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP61351352
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberAP61351352
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: