Provider Demographics
NPI:1689046500
Name:TUN, CHRISTINE CHANMYAETHU (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CHANMYAETHU
Last Name:TUN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:CHANMYAETHU
Other - Last Name:GYLLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:8401 CONNECTICUT AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5832
Mailing Address - Country:US
Mailing Address - Phone:301-949-8100
Mailing Address - Fax:301-962-7450
Practice Address - Street 1:8401 CONNECTICUT AVE STE 800
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5832
Practice Address - Country:US
Practice Address - Phone:301-949-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4551363A00000X
MDC0007976363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant