Provider Demographics
NPI:1528205812
Name:HOFSTETTER, CHRISTINA ANN (LMP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ANN
Last Name:HOFSTETTER
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 1:4206 W. 24TH AVE
Mailing Address - Street 2:SUITE B103
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338
Mailing Address - Country:US
Mailing Address - Phone:509-783-2949
Mailing Address - Fax:509-783-2949
Practice Address - Street 1:4206 W. 24TH AVE
Practice Address - Street 2:SUITE B103
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338
Practice Address - Country:US
Practice Address - Phone:509-783-2949
Practice Address - Fax:509-783-2949
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60031975225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist