Provider Demographics
NPI:1346619939
Name:WORTHEN, CHRISTIE SEE-YEE (AGNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:SEE-YEE
Last Name:WORTHEN
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:SEE-YEE
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1901 S CEDAR ST STE 301
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2302
Mailing Address - Country:US
Mailing Address - Phone:253-572-7320
Mailing Address - Fax:
Practice Address - Street 1:1901 S CEDAR ST STE 301
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2302
Practice Address - Country:US
Practice Address - Phone:253-572-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60590542363L00000X
WAAP 60590542363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology