Provider Demographics
NPI:1699184937
Name:HOLSTEN, CHRISTIAN (ATC, AT/L, LMP)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:HOLSTEN
Suffix:
Gender:F
Credentials:ATC, AT/L, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3608
Mailing Address - Country:US
Mailing Address - Phone:509-995-5188
Mailing Address - Fax:
Practice Address - Street 1:1929 43RD AVE E
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-3297
Practice Address - Country:US
Practice Address - Phone:206-328-5466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1 603351182255A2300X
WAMA 60487459225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer