Provider Demographics
NPI:1215369632
Name:CHRISTENSEN SPINE AND WELLNESS, LLC
Entity Type:Organization
Organization Name:CHRISTENSEN SPINE AND WELLNESS, LLC
Other - Org Name:ACTION CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-489-0469
Mailing Address - Street 1:284 LEE ST SW
Mailing Address - Street 2:SUITE 128
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4403
Mailing Address - Country:US
Mailing Address - Phone:360-489-0469
Mailing Address - Fax:360-489-0468
Practice Address - Street 1:284 LEE ST SW STE 128
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4403
Practice Address - Country:US
Practice Address - Phone:360-489-0469
Practice Address - Fax:360-489-0468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603288751111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000059454Medicare PIN
WAV10641Medicare UPIN