Provider Demographics
NPI:1891134110
Name:CHRISTIE, MARTHA PAULINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:PAULINE
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6028 HANNAH PIERCE RD W
Mailing Address - Street 2:APT D
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-4229
Mailing Address - Country:US
Mailing Address - Phone:253-355-1571
Mailing Address - Fax:
Practice Address - Street 1:12811 MERIDIAN E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-5646
Practice Address - Country:US
Practice Address - Phone:253-770-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60293526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist