Healthcare Provider Details

I. General information

NPI: 1821521758
Provider Name (Legal Business Name): KRISTIN SAWYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8116 112TH STREET CT E STE A
PUYALLUP WA
98373-7816
US

IV. Provider business mailing address

500 SW 7TH ST STE A205
RENTON WA
98057-2983
US

V. Phone/Fax

Practice location:
  • Phone: 877-522-1275
  • Fax: 833-888-7145
Mailing address:
  • Phone: 509-222-1275
  • Fax: 509-491-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61199989
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60466870
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: