Healthcare Provider Details

I. General information

NPI: 1598262206
Provider Name (Legal Business Name): KRISTEN JOANNE BALLINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3916
US

IV. Provider business mailing address

8615 55TH AVE S
SEATTLE WA
98118-4708
US

V. Phone/Fax

Practice location:
  • Phone: 509-860-4872
  • Fax:
Mailing address:
  • Phone: 509-860-4872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD61195641
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD61195641
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: