MEDICARE: KRISTEN HOWARD

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	101YM0800X	Mental Health Counselor	MC 60704218	WA

General Provider Information

NPI Number	:	1407388606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN HOWARD

Provider Business Mailing Address
First Line	:	3801 S ZINTEL WAY
Second Line	:	SUITE 120
City	:	KENNEWICK
State	:	WA
Zip	:	99337-5097
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 COLUMBIA PARK TRL
Second Line	:	#103
City	:	RICHLAND
State	:	WA
Zip	:	99352-4772
Country	:	US
Telephone Number	:	509-591-0462
Fax Number	:

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

Provider Enumeration Date	:	03/28/2017
Last Update Date	:	03/28/2017

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