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General NPI Number Information
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NPI Number | 1154423259
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Entity Type | Individual
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Provider Name | KRISTINA M MERRIMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 16810 MERIDIAN E STE J107
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City | PUYALLUP
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State | WA
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Zip | 98375-9604
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Country | US
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Telephone | 253-848-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 3722 BROWNS POINT BLVD
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City | TACOMA
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State | WA
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Zip | 98422
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Country | US
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Telephone | 253-334-9514
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE10429
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 00010429
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License Number State | WA
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