Provider Demographics
NPI:1033490602
Name:GREEN, CHRISTIAN HILLARY (LMP, CLT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:HILLARY
Last Name:GREEN
Suffix:
Gender:M
Credentials:LMP, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18217 137TH PL SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-5060
Mailing Address - Country:US
Mailing Address - Phone:206-407-9251
Mailing Address - Fax:
Practice Address - Street 1:3250 AIRPORT WAY S STE 305
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2173
Practice Address - Country:US
Practice Address - Phone:206-407-9251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist