Provider Demographics
NPI:1225835143
Name:MCMILLAN, KRISTEN RAY
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RAY
Last Name:MCMILLAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W 5TH AVE APT 708
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2778
Mailing Address - Country:US
Mailing Address - Phone:843-992-5075
Mailing Address - Fax:
Practice Address - Street 1:707 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2832
Practice Address - Country:US
Practice Address - Phone:843-992-5075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician