Provider Demographics
NPI:1922140904
Name:MUTH, CHRISTINE A (ARNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:MUTH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18215 E APPLEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99016-9564
Mailing Address - Country:US
Mailing Address - Phone:509-924-3374
Mailing Address - Fax:
Practice Address - Street 1:18215 E APPLEWAY AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99016-9564
Practice Address - Country:US
Practice Address - Phone:509-924-3374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9620006Medicaid
WA9620006Medicaid
WAP26016Medicare UPIN