Provider Demographics
NPI:1346592995
Name:FRUEH, CHRISTINA LEIGH
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:LEIGH
Last Name:FRUEH
Suffix:
Gender:F
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 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-5020
Mailing Address - Country:US
Mailing Address - Phone:253-931-4927
Mailing Address - Fax:
Practice Address - Street 1:11815 SE 304TH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-3115
Practice Address - Country:US
Practice Address - Phone:253-931-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI 60241543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WASI 60241543OtherWA-DEPARTMENT OF HEALTH