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General NPI Number Information
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NPI Number | 1598918088
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Entity Type | Individual
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Provider Name | HILLARY KRUEGER ADRIAN PAC
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Gender | Female
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 450 S KITSAP BLVD STE 100
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City | PORT ORCHARD
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State | WA
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Zip | 98366-3709
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Country | US
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Telephone | 360-744-6275
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Fax | 360-744-6270
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Provider Business Mailing Address
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Address Line | 450 S KITSAP BLVD STE 100
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City | PORT ORCHARD
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State | WA
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Zip | 98366-3709
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Country | US
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Telephone | 360-744-6275
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Fax | 360-744-6270
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 4660
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License Number State | AZ
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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 | PA60048381
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License Number State | WA
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