Provider Demographics
NPI:1063428464
Name:SCHAAF, KRISTIN K (PHD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:K
Last Name:SCHAAF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:J
Other - Last Name:KOLLMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4310 COLBY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2338
Mailing Address - Country:US
Mailing Address - Phone:425-252-7000
Mailing Address - Fax:425-252-7005
Practice Address - Street 1:4310 COLBY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2338
Practice Address - Country:US
Practice Address - Phone:425-252-7000
Practice Address - Fax:425-252-7005
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002397103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB14395Medicare ID - Type UnspecifiedPROVIDER NUMBER
WAS51517Medicare UPIN