Provider Demographics
NPI:1447618764
Name:MARTIN, KRISTAL J (ARNP)
Entity type:Individual
Prefix:
First Name:KRISTAL
Middle Name:J
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:BELFAIR
Mailing Address - State:WA
Mailing Address - Zip Code:98528-0277
Mailing Address - Country:US
Mailing Address - Phone:360-275-6711
Mailing Address - Fax:360-275-6224
Practice Address - Street 1:490 NE OLD BELFAIR HWY
Practice Address - Street 2:
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98528-9637
Practice Address - Country:US
Practice Address - Phone:360-275-6711
Practice Address - Fax:360-275-6224
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60949923363LF0000X
FLF1215218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily