Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 15716 |
NPI | 1215175831 |
---|---|
Provider Name | Mrs. Christine Lynn King |
First Address | Silverdale, WA 98383-6000 |
Second Address | Silverdale, WA 98383-6000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2009 |
Last Update Date | 04/02/2009 |