Provider Demographics
NPI:1023098860
Name:CHRIST, CONSTANCE B (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:B
Last Name:CHRIST
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:509-838-2531
Mailing Address - Fax:
Practice Address - Street 1:610 S SHERMAN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1342
Practice Address - Country:US
Practice Address - Phone:509-838-2531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101222253207RN0300X
WAMD60202978207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA227154OtherSOUTHERN HEALTH
VA72648OtherCOMMUNITY HEALTH
VA101799Medicaid
WA1023098860Medicaid
VA101799OtherANTHEM SVC HEALTHKEEPERS
VA010022797Medicaid
VA72648Medicaid
VA2115530OtherMAMSI
VA4044574OtherCIGNA
VA227154OtherSOUTHERN HEALTH
VA72648OtherCOMMUNITY HEALTH
VA010022797Medicaid