Provider Demographics
NPI:1609940691
Name:CHRISTIAN, JENNIFER A (LAC)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:A
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28083
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1083
Mailing Address - Country:US
Mailing Address - Phone:206-817-1927
Mailing Address - Fax:
Practice Address - Street 1:4500 9TH AVE NE
Practice Address - Street 2:SUITE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4737
Practice Address - Country:US
Practice Address - Phone:206-817-1927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002066171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist