Provider Demographics
NPI:1346805959
Name:ADAMS, CRISTANIE K (LMP)
Entity Type:Individual
Prefix:
First Name:CRISTANIE
Middle Name:K
Last Name:ADAMS
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 1:2430 96TH ST S APT G8
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-7859
Mailing Address - Country:US
Mailing Address - Phone:253-226-5517
Mailing Address - Fax:
Practice Address - Street 1:2430 96TH ST S APT G8
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-7859
Practice Address - Country:US
Practice Address - Phone:253-226-5517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60885802225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist