MEDICARE: DR. KRISTAN DZIURZYNSKI

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	106H00000X	Marriage & Family Therapist
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1144833450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTAN DZIURZYNSKI

Provider Business Mailing Address
First Line	:	3250 AIRPORT WAY S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98134-2167
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 AIRPORT WAY S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98134-2167
Country	:	US
Telephone Number	:	206-906-9127
Fax Number	:

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

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	03/25/2024

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