| Kristin Roessler, Llc | |
|
512 91st Ave Ne Ste C Lake Stevens WA 98258-2566 | |
| (425) 870-0895 | |
| (425) 377-1764 |
| Full Name | Kristin Roessler, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 512 91st Ave Ne Ste C, Lake Stevens, Washington |
| Authorized Official Name and Position | Kristin Lee Roessler (OWNER) |
| Authorized Official Contact | 4258700895 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristin Roessler, Llc 512 91st Ave Ne Ste C Lake Stevens WA 98258-2566 Ph: (425) 870-0895 | Kristin Roessler, Llc 512 91st Ave Ne Ste C Lake Stevens WA 98258-2566 Ph: (425) 870-0895 |
| NPI Number | 1033624556 |
|---|---|
| Provider Enumeration Date | 12/06/2017 |
| Last Update Date | 08/09/2021 |
| Certification Date | 08/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033624556 | NPI | - | NPPES |
| 1649365149 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | LW60591592 (Washington) | Primary |
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