Provider Demographics
NPI:1598859811
Name:CHRISTENSEN, ROYDEN E (DO)
Entity Type:Individual
Prefix:DR
First Name:ROYDEN
Middle Name:E
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55-220 KULANUI ST.
Mailing Address - Street 2:BYUH #1728
Mailing Address - City:LAIE
Mailing Address - State:HI
Mailing Address - Zip Code:96762-1293
Mailing Address - Country:US
Mailing Address - Phone:808-675-3510
Mailing Address - Fax:808-675-3506
Practice Address - Street 1:55-220 KULANUI ST
Practice Address - Street 2:BRIGHAM YOUNG UNIVERSITY HAWAII HEALTH CENTER
Practice Address - City:LAIE
Practice Address - State:HI
Practice Address - Zip Code:96762-1293
Practice Address - Country:US
Practice Address - Phone:808-675-3510
Practice Address - Fax:808-675-3506
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
911019392OtherCOMMERCIAL
WA157931OtherL & I
25690OtherGROUP HEALTH
WA8296097OtherCHPW
WA9392CHOtherREGENCE
WA8296097Medicaid
GAB27984Medicare ID - Type Unspecified
WA8296097Medicaid
WA9392CHOtherREGENCE
25690OtherGROUP HEALTH
WAH23835Medicare UPIN