Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH00001479 | WA |
N | 111NR0400X | Rehabilitation Chiropractor | CH00001479 | WA |
N | 111NS0005X | Chiropractic Sports Physician | CH00001479 | WA |
NPI | 1013900372 |
---|---|
Provider Name | Kim D Christensen |
First Address | Vancouver, WA 98684-4009 |
Second Address | Vancouver, WA 98684-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 24/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
022898 | (05) | OR |
253358 | L&I (01) | WA |
8378838 | (05) | WA |
8931612 | CRIME VICTIMS (01) | WA |
P00231843 | RR MEDICARE (01) | |
T02552 | (02) |