Provider Demographics
NPI:1043330756
Name:CHRISTINA M RUST DPT & ASSOCIATES PC
Entity Type:Organization
Organization Name:CHRISTINA M RUST DPT & ASSOCIATES PC
Other - Org Name:7BWELL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUST
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PA-C
Authorized Official - Phone:208-290-2856
Mailing Address - Street 1:801 PINE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1682
Mailing Address - Country:US
Mailing Address - Phone:208-290-2856
Mailing Address - Fax:208-290-2856
Practice Address - Street 1:801 PINE ST STE 2
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1682
Practice Address - Country:US
Practice Address - Phone:208-290-2856
Practice Address - Fax:208-290-2856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT1097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID10510026OtherREGENCE OF IDAHO
ID805048700Medicaid
IDTD058OtherBLUE CROSS IDAHO
WA0200479OtherDEPT OF L&I WASHINGTON
IDDE6511OtherRAILROAD MEDICARE NUMBER
IDDE6511OtherRAILROAD MEDICARE NUMBER