Provider Demographics
NPI:1356851067
Name:DECHRISTOPHER, ANTHONY (NP-C, RN)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:DECHRISTOPHER
Suffix:
Gender:M
Credentials:NP-C, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 NW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1612
Mailing Address - Country:US
Mailing Address - Phone:541-504-1809
Mailing Address - Fax:
Practice Address - Street 1:2600 SW HOLDEN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3505
Practice Address - Country:US
Practice Address - Phone:206-933-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-08
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60767128163WP0809X
WAAP60909309207Q00000X
OR201904340NP-PP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine