Provider Demographics
NPI:1306180773
Name:CHRISTIANSEN, TONIE (LMP)
Entity Type:Individual
Prefix:
First Name:TONIE
Middle Name:
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E HASTINGS RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-4901
Mailing Address - Country:US
Mailing Address - Phone:509-340-3303
Mailing Address - Fax:
Practice Address - Street 1:101 E HASTINGS RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-4901
Practice Address - Country:US
Practice Address - Phone:509-340-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-24
Last Update Date:2012-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60282867171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor