Provider Demographics
NPI:1659408599
Name:WHITE, CHRISTINE S (LMT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:S
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 4TH AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98161-1017
Mailing Address - Country:US
Mailing Address - Phone:206-622-9001
Mailing Address - Fax:206-622-4311
Practice Address - Street 1:1215 4TH AVE STE 1000
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98161-1017
Practice Address - Country:US
Practice Address - Phone:206-622-9001
Practice Address - Fax:206-622-4311
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015861225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUNIFIED BUSINESS IDOther602151970