Provider Demographics
NPI:1386357713
Name:GITTLESON, KARIS
Entity type:Individual
Prefix:
First Name:KARIS
Middle Name:
Last Name:GITTLESON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 NE 45TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4631
Mailing Address - Country:US
Mailing Address - Phone:206-694-5700
Mailing Address - Fax:
Practice Address - Street 1:1107 NE 45TH ST STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4631
Practice Address - Country:US
Practice Address - Phone:206-694-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist