Healthcare Provider Details

I. General information

NPI: 1790699940
Provider Name (Legal Business Name): KRISTE COLLEY-KUMMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8514 W GAGE BLVD STE 10
KENNEWICK WA
99336-8108
US

IV. Provider business mailing address

8514 W GAGE BLVD STE 10
KENNEWICK WA
99336-8108
US

V. Phone/Fax

Practice location:
  • Phone: 509-521-6263
  • Fax:
Mailing address:
  • Phone: 509-521-6263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70135403
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: