Provider Demographics
NPI:1710918602
Name:STEPHENS, CHRISTOPHER E
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:E
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 NE UNIVERSITY VILLAGE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5016
Mailing Address - Country:US
Mailing Address - Phone:206-525-0705
Mailing Address - Fax:
Practice Address - Street 1:2700 NE UNIVERSITY VILLAGE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5016
Practice Address - Country:US
Practice Address - Phone:206-525-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP67961183500000X
WAIR00053226390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program