Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 6201 | WA |
NPI | 1073623757 |
---|---|
Provider Name | Richard D Christensen |
First Address | Yakima, WA 98902 |
Second Address | Yakima, WA 98902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |