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General NPI Number Information
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NPI Number | 1265673891
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Entity Type | Individual
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Provider Name | KRISTEN JAN KAFER PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 2901 174TH ST NE
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City | MARYSVILLE
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State | WA
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Zip | 98271-4743
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Country | US
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Telephone | 360-454-1900
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Fax | 360-454-1991
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Provider Business Mailing Address
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Address Line | PO BOX 5127
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City | EVERETT
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State | WA
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Zip | 98206-5127
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Country | US
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Telephone | 360-454-1900
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Fax | 360-454-1991
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60677484
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4367
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2529 - 023
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MED-PAC-LIC-86814
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License Number State | MT
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