Provider Demographics
NPI:1992500722
Name:WOOD, KRISTOPHER (SRNA)
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:
Last Name:WOOD
Suffix:
Gender:
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 N CAVALIER RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99016-9204
Mailing Address - Country:US
Mailing Address - Phone:425-327-2601
Mailing Address - Fax:
Practice Address - Street 1:101 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2364
Practice Address - Country:US
Practice Address - Phone:425-327-2601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program