Provider Demographics
NPI:1639516321
Name:POULIN-HARNOIS, CHRISTELLE MARIE SANDIE (MDCM)
Entity Type:Individual
Prefix:MS
First Name:CHRISTELLE
Middle Name:MARIE SANDIE
Last Name:POULIN-HARNOIS
Suffix:
Gender:F
Credentials:MDCM
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE (SEATTLE CHILDREN'S HOSPITAL)
Mailing Address - Street 2:DEPT OF ANESTHESIOLOGY MB 11.500
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE (SEATTLE CHILDREN'S HOSPITAL)
Practice Address - Street 2:DEPT OF ANESTHESIOLOGY MB 11.500
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-987-3996
Practice Address - Fax:206-987-3935
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAFE60386951390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program