Provider Demographics
NPI:1487354551
Name:KAITRYN, EMERALD (MS, GC)
Entity type:Individual
Prefix:
First Name:EMERALD
Middle Name:
Last Name:KAITRYN
Suffix:
Gender:F
Credentials:MS, GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DIVISION OF MEDICAL GENETICS, BOX 357720
Mailing Address - Street 2:HEALTH SCIENCES BUILDING 1705 NE PACIFIC ST, RM K236F
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195
Mailing Address - Country:US
Mailing Address - Phone:206-543-4184
Mailing Address - Fax:206-543-8820
Practice Address - Street 1:DIVISION OF MEDICAL GENETICS, BOX
Practice Address - Street 2:HEALTH SCIENCES BUILDING 1705 NE PACIFIC ST, RM K236F
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195
Practice Address - Country:US
Practice Address - Phone:206-543-4184
Practice Address - Fax:206-543-8820
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGCPL.GP.61414286OtherWASHINGTON DEPARTMENT OF HEALTH