| NPI | 1427260504 |
|---|---|
| Former Name | KRISTIN LEE DOUGLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10005166) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005166) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-10-21 |