Provider Demographics
NPI:1427714427
Name:LAURENTE, KRISTINA (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:LAURENTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 TERRY AVE UNIT 837
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2452
Mailing Address - Country:US
Mailing Address - Phone:817-937-9133
Mailing Address - Fax:
Practice Address - Street 1:5802 134TH PL SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-9426
Practice Address - Country:US
Practice Address - Phone:425-332-6179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-14
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61311754183500000X
HIPH-4662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist