Provider Demographics
NPI:1255474367
Name:CHRISTENSON, DONALD M
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:M
Last Name:CHRISTENSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1313
Mailing Address - Country:US
Mailing Address - Phone:509-624-1308
Mailing Address - Fax:509-624-5537
Practice Address - Street 1:502 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1313
Practice Address - Country:US
Practice Address - Phone:509-624-1308
Practice Address - Fax:509-624-5537
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOI00000060222Z00000X
WAPS00000059224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CPO550OtherAMERICAN BOARD CERT O&P