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General NPI Number Information
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NPI Number | 1972626034
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Entity Type | Individual
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Provider Name | KRISTY JEAN WEISS LMP
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 11821 NE 128TH ST SUITE C
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City | KIRKLAND
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State | WA
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Zip | 98034-7210
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Country | US
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Telephone | 425-285-1250
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Fax | 425-285-1255
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Provider Business Mailing Address
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Address Line | PO BOX 2170
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City | SUMNER
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State | WA
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Zip | 98390-0480
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Country | US
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Telephone | 253-840-2313
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Fax | 253-840-6340
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60558965
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License Number State | WA
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