Healthcare Provider Details

I. General information

NPI: 1881793842
Provider Name (Legal Business Name): KRISTEN NICOLE HAYWARD MD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE M/S R-5420
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE M/S R-5420
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2057
  • Fax: 206-987-5060
Mailing address:
  • Phone: 206-987-2057
  • Fax: 206-987-5060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License NumberMD00043647
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: