Provider Demographics
NPI:1114137197
Name:CHRISTIAN, CATHALENE BLAKE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CATHALENE
Middle Name:BLAKE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CATHALENE
Other - Middle Name:ANN
Other - Last Name:BLAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3800 RESERVOIR RD NW
Mailing Address - Street 2:PHC 1
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2113
Mailing Address - Country:US
Mailing Address - Phone:202-444-6598
Mailing Address - Fax:202-444-2130
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-6598
Practice Address - Fax:202-444-2130
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA030457363AS0400X
VA0110002395363AS0400X
MDC0003285363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical