Provider Demographics
NPI:1417148628
Name:CHRISTEN, SHANNON MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:MARIE
Last Name:CHRISTEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13515 NE 175TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8566
Mailing Address - Country:US
Mailing Address - Phone:425-485-8430
Mailing Address - Fax:425-485-8259
Practice Address - Street 1:13515 NE 175TH ST STE D
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8566
Practice Address - Country:US
Practice Address - Phone:425-485-8430
Practice Address - Fax:425-485-8259
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2275231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7133622Medicaid
WA0183599OtherWA STATE L&I PROVIDER
8806255Medicare PIN