Provider Demographics
NPI:1154710119
Name:BAYNE, KIRSTEN MARIE (CPO, NRP)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MARIE
Last Name:BAYNE
Suffix:
Gender:F
Credentials:CPO, NRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 5TH ST SE STE 1700
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-4602
Mailing Address - Country:US
Mailing Address - Phone:253-840-0227
Mailing Address - Fax:253-840-1176
Practice Address - Street 1:1450 5TH ST SE STE 1700
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4602
Practice Address - Country:US
Practice Address - Phone:253-840-0227
Practice Address - Fax:253-840-1176
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208354146L00000X
OR139964146L00000X
WAOI 60474160222Z00000X
WAPS60564404224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist