Provider Demographics
NPI:1073862645
Name:CHRISTEN, DACIA RENAE (MA, CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:DACIA
Middle Name:RENAE
Last Name:CHRISTEN
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S CONKLIN RD
Mailing Address - Street 2:#N-5
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-0015
Mailing Address - Country:US
Mailing Address - Phone:509-832-1950
Mailing Address - Fax:
Practice Address - Street 1:8502 N NEVADA ST
Practice Address - Street 2:STE2
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-7395
Practice Address - Country:US
Practice Address - Phone:509-487-2958
Practice Address - Fax:509-487-3025
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist