Healthcare Provider Details

I. General information

NPI: 1558597153
Provider Name (Legal Business Name): KRISTAN R. SCHLATTER LPO CPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 EASTLAKE AVE E SUITE 300
SEATTLE WA
98109-5546
US

IV. Provider business mailing address

501 EASTLAKE AVE E SUITE 300
SEATTLE WA
98109-5546
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-4026
  • Fax: 206-598-4761
Mailing address:
  • Phone: 206-598-4026
  • Fax: 206-598-4761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberOI60026714
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberPS60078067
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: