Provider Demographics
NPI:1316218779
Name:PODHORA, CHRISTIE JOYCE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIE
Middle Name:JOYCE
Last Name:PODHORA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:800 NE 136TH AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6933
Mailing Address - Country:US
Mailing Address - Phone:360-397-9554
Mailing Address - Fax:360-952-9148
Practice Address - Street 1:800 NE 136TH AVE
Practice Address - Street 2:STE 220
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6933
Practice Address - Country:US
Practice Address - Phone:360-397-9554
Practice Address - Fax:360-952-9148
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR082011115N3363LA2200X
WAAP30004111363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health