Healthcare Provider Details

I. General information

NPI: 1184676116
Provider Name (Legal Business Name): KRISTOFOR D NORLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 COLBY AVE
EVERETT WA
98201-1665
US

IV. Provider business mailing address

10432 208TH AVE SE
SNOHOMISH WA
98290-7220
US

V. Phone/Fax

Practice location:
  • Phone: 425-261-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberMD00044689
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD00044689
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: