Healthcare Provider Details

I. General information

NPI: 1184943995
Provider Name (Legal Business Name): KRISTEN E. NOVEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 5TH AVE W
SEATTLE WA
98119-2212
US

IV. Provider business mailing address

2810 5TH AVE W
SEATTLE WA
98119-2212
US

V. Phone/Fax

Practice location:
  • Phone: 206-290-3957
  • Fax: 866-529-9739
Mailing address:
  • Phone: 206-290-3957
  • Fax: 866-529-9739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA60987901
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number05682
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: