MEDICARE: KRISTINA D COYLE LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LW60185890	WA
2	101YM0800X	Mental Health Counselor	LW60185890	WA

General Provider Information

NPI Number	:	1073705075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA D COYLE LICSW

Provider Business Mailing Address
First Line	:	105 E DIVISION ST STE 2
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1288
Country	:	US
Telephone Number	:	425-344-9722
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 E DIVISION ST STE 2
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1288
Country	:	US
Telephone Number	:	425-344-9722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	05/02/2025

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Directions to “ KRISTINA D COYLE LICSW” Practice Location

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