Provider Demographics
NPI:1528103264
Name:STODDARD, KRISTINA L (LAC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:L
Last Name:STODDARD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 HAROLD PL NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2809
Mailing Address - Country:US
Mailing Address - Phone:206-335-0895
Mailing Address - Fax:
Practice Address - Street 1:8800 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-3042
Practice Address - Country:US
Practice Address - Phone:206-335-0895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002112171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist