Healthcare Provider Details

I. General information

NPI: 1669748604
Provider Name (Legal Business Name): KATHRYN HRYNIEWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2012
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 SE PROFESSIONAL MALL BLVD STE 104
PULLMAN WA
99163-5423
US

IV. Provider business mailing address

4800 SAND POINT WAY NE A-5850
SEATTLE WA
98105-2864
US

V. Phone/Fax

Practice location:
  • Phone: 509-332-2605
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberML60292823
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60577173
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: