Healthcare Provider Details

I. General information

NPI: 1043138308
Provider Name (Legal Business Name): ASHLEY LAUREN KROMBACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 MORRIS AVE S UNIT A
RENTON WA
98055-3301
US

IV. Provider business mailing address

1719 MORRIS AVE S UNIT A
RENTON WA
98055-3301
US

V. Phone/Fax

Practice location:
  • Phone: 330-247-8468
  • Fax:
Mailing address:
  • Phone: 330-247-8468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: