Provider Demographics
NPI:1134361413
Name:TOMA, CHRISTINE A (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:TOMA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 132ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7203
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:11700 MUKILTEO SPEEDWAY
Practice Address - Street 2:SUITE 503
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5432
Practice Address - Country:US
Practice Address - Phone:425-349-9692
Practice Address - Fax:425-349-9694
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60069091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0247440OtherDEPT OF L&I
WA8538365OtherDSHS
WA3045TOOtherREGENCE
WA4293TOOtherREGENCE
WA4369TOOtherREGENCE
WA4936TOOtherREGENCE
WA6493TOOtherREGENCE
WA8950945OtherCRIME VICTIMS
WA5467TOOtherREGENCE
WA4369TOOtherREGENCE