Healthcare Provider Details

I. General information

NPI: 1376213504
Provider Name (Legal Business Name): KRISTEN ALYSE EISENBERG FNP-C, ACNP-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIRSTEN ALYSE SPICHER

II. Dates (important events)

Enumeration Date: 09/19/2021
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 S J ST STE 120
TACOMA WA
98405-4965
US

IV. Provider business mailing address

1812 S J ST STE 120
TACOMA WA
98405-4965
US

V. Phone/Fax

Practice location:
  • Phone: 253-428-2200
  • Fax: 253-428-2299
Mailing address:
  • Phone: 253-428-2200
  • Fax: 253-428-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP70026462
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP70026462
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN70021539
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: