Healthcare Provider Details

I. General information

NPI: 1194086694
Provider Name (Legal Business Name): KRISTEN DENISE SCATLIFFE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 YAKIMA AVE STE 300
TACOMA WA
98405-5309
US

IV. Provider business mailing address

6401 WASHINGTON AVE UNIT 102
HOUSTON TX
77007-4662
US

V. Phone/Fax

Practice location:
  • Phone: 253-363-8700
  • Fax:
Mailing address:
  • Phone: 305-458-0945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC4101
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MA09734800
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2018-01413
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD2021-0019
License Number StateNM
# 6
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA09734800
License Number StateNJ
# 7
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD2021-0019
License Number StateNM
# 8
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2018-01413
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC4101
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: