Healthcare Provider Details

I. General information

NPI: 1225619869
Provider Name (Legal Business Name): KRISTIN P DORN NBC- HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 SAND POINT WAY NE STE 100
SEATTLE WA
98105-3941
US

IV. Provider business mailing address

4540 SAND POINT WAY NE STE 100
SEATTLE WA
98105-3941
US

V. Phone/Fax

Practice location:
  • Phone: 206-575-8880
  • Fax:
Mailing address:
  • Phone: 206-575-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: