1114905007 NPI number — DR. CHRISTOPHER M. KROL MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114905007 NPI number — DR. CHRISTOPHER M. KROL MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KROL

Provider First Name:

CHRISTOPHER

Provider Middle Name:

M.

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1114905007

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

09/08/2025

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

19020 33RD AVE W STE 210

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LYNNWOOD

Provider Business Mailing Address State Name:

WA

Provider Business Mailing Address Postal Code:

98036-4748

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

425-563-1500

Provider Business Mailing Address Fax Number:

425-563-1374

Provider First Line Business Practice Location Address:

2401 SHADELANDERS DRIVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

WALNUT CREEK

Provider Business Practice Location Address State Name:

CA

Provider Business Practice Location Address Postal Code:

94598

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

510-425-3000

Provider Business Practice Location Address Fax Number:

425-563-1374

Provider Enumeration Date:

01/03/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  C171861 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 2085R0202X , with the licence number: 4301503494 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 12343 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: MD00043543 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 0187099 . This is a "L&I-RADIA REST OF WA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 8397887 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: 1114905007 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
• Identifier: 0385164 . This is a "L&I-SOUTH SOUND RADIOLOGY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0187098 . This is a "L&I-EVERGREEN RADIA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0381107 . This is a "L&I-RADIA SEATTLE COUNTY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0381109 . This is a "L&I-SWEDISH RADIA EDMONDS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".