Provider Demographics
NPI:1285677625
Name:CHRISTENSEN, JAMES ALLEN (PA-C, PHD, BCETS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLEN
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:PA-C, PHD, BCETS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 CHAMPION ST
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-1914
Mailing Address - Country:US
Mailing Address - Phone:253-590-8190
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY STOP CODES-01
Practice Address - Street 2:SYSTEMS REDESIGN AND CREDENTIALING & PRIVILEGING
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:253-583-1404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60120197363AM0700X, 363AS0400X
AZ1009363AM0700X, 363AS0400X
CA10374363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical