KRISTIE MICHELLE MATTERN (NPI# 1023392529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023392529 |
| Entity Type | Individual |
| Full Name | KRISTIE MICHELLE MATTERN |
| Credential | PAC |
| Practice Address |
5427 S Birmingham St Tacoma WA 98409-5417 |
| Mailing Address |
13114 120th Ave Ne Kirkland WA 98034-3014 |
| Practice Telephone | 4258216000 |
| Mailing Telephone | 4258216000 |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2014-09-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA10003450 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA10003450 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5427 S BIRMINGHAM ST |
| City | TACOMA |
| State | WA |
| Zip Code | 98409-5417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053942805 | Terah Jo Barker | Behavior Technician | 4301 South Pine St., Suite 505, Tacoma, WA 98409 | 2020-01-30 |
| 1427526797 | Carrissa Bentley | Social Worker | 3901 S. Fife Street, Tacoma, WA 98409 | 2018-11-05 |
| 1396255972 | Julie Ann Sunada | Nurse Practitioner | 2505 S 38th St Ste 109, Tacoma, WA 98409 | 2017-10-09 |
| 1306389820 | Laura Town | Chiropractor | 3640 S Cedar St, Ste P, Tacoma, WA 98409 | 2016-12-01 |
| 1114476082 | Chelsea Marie Jensen | Massage Therapist | 701 Commerce Street Apartment 307, Tacoma, WA 98409 | 2016-10-03 |
| 1831574730 | Artika Naidu | Optometrist | 4502 South Steele #700, Located Inside Macy's Lenscrafters, Tacoma, WA 98409 | 2015-07-22 |
| 1972918399 | Tacoma Dental and Implant Center Ps | Clinic/Center | 4704 South Oakes St #103, Tacoma, WA 98409 | 2014-06-24 |
| 1457795957 | Ana Amparo Penas Vasquez | Clinical Nurse Specialist | 2505 South 38th St, Bldg A Suite 109, Tacoma, WA 98409 | 2013-04-26 |
| 1033452156 | Richard William Solitaire | Counselor | 4301 S. Pine St., 30-19, Tacoma, WA 98409 | 2013-03-27 |
| 1790042810 | Tara Kerin Garland | Counselor | 5921 S. Verde St., Tacoma, WA 98409 | 2012-04-13 |
| Find all providers in zip 98409 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124147087 | Aniko A Szentes | Physician Assistant | 3708 55th St Ne, Tacoma, WA 98422-4571 | 2007-03-29 |
| 1053324186 | Tommy Lamar Jackson | Physician Assistant | 1802 Yakima Ave Ste 204, Tacoma, WA 98405-5304 | 2006-08-13 |
| 1396763140 | Jerry John Papson | Physician Assistant | 1812 South J St, Suite 210, Tacoma, WA 98405-4964 | 2006-07-18 |
| 1215996798 | Jill Tricia Eggersknight | Physician Assistant | Orthopedic Surgery Service, Attn: Mchj-sop, Tacoma, WA 98431-0001 | 2006-03-22 |
| 1588127062 | Sung Ho Kim | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2019-04-10 |
| 1215407770 | Monica Huang | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2018-11-27 |
| 1154803237 | Limary Gonzalez | Physician Assistant | 1717 S J St, Tacoma, WA 98405-4933 | 2018-09-05 |
| 1942725072 | Breanna Lynn Polk | Physician Assistant | 1724 W Union Ave, Tacoma, WA 98405-2099 | 2017-08-09 |
| 1104354190 | Samantha Sokol | Physician Assistant | 1717 S J St, Tacoma, WA 98405-4933 | 2017-06-02 |
| 1548662752 | Tomasz Gondek | Physician Assistant | 209 Martin Luther King Jr Way, Tacoma, WA 98405-4265 | 2014-09-18 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.