Provider Demographics
NPI:1336326008
Name:GREENE, CHRISTINA (LMP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:GREENE
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 1:1210 10TH ST
Mailing Address - Street 2:#201
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7063
Mailing Address - Country:US
Mailing Address - Phone:360-752-0941
Mailing Address - Fax:
Practice Address - Street 1:1210 10TH ST
Practice Address - Street 2:#201
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7063
Practice Address - Country:US
Practice Address - Phone:360-752-0941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022396225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist