Provider Demographics
NPI:1710206537
Name:CABLE, CHRISTIE S (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:S
Last Name:CABLE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 SILVER LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-3200
Mailing Address - Country:US
Mailing Address - Phone:703-922-4604
Mailing Address - Fax:703-922-0264
Practice Address - Street 1:7100 SILVER LAKE BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-3200
Practice Address - Country:US
Practice Address - Phone:703-922-4604
Practice Address - Fax:703-922-0264
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020078741835P0018X
PARP034443L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist