Provider Demographics
NPI:1689990400
Name:DAVISON, CHRISTINE MARIA (OT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARIA
Last Name:DAVISON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33822 118TH PL SE
Mailing Address - Street 2:
Mailing Address - City:SULTAN
Mailing Address - State:WA
Mailing Address - Zip Code:98294-9673
Mailing Address - Country:US
Mailing Address - Phone:360-793-1663
Mailing Address - Fax:
Practice Address - Street 1:33822 118TH PL SE
Practice Address - Street 2:
Practice Address - City:SULTAN
Practice Address - State:WA
Practice Address - Zip Code:98294-9673
Practice Address - Country:US
Practice Address - Phone:360-793-1663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600162520225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist