Provider Demographics
NPI:1114159803
Name:CHRISTENSEN, ASHLEY MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5590 WEST CHANDLER BOULEVARD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226
Mailing Address - Country:US
Mailing Address - Phone:480-786-4969
Mailing Address - Fax:480-786-5118
Practice Address - Street 1:5590 W CHANDLER BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3697
Practice Address - Country:US
Practice Address - Phone:480-786-4969
Practice Address - Fax:480-786-5118
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8568174400000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ451514Medicaid
AZ451514Medicaid