Provider Demographics
NPI:1275665713
Name:CHRISTIE, WILLIAM ALAN
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ALAN
Last Name:CHRISTIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:ALAN
Other - Last Name:CHRISTIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMP
Mailing Address - Street 1:1001 COOPER POINT RD SW
Mailing Address - Street 2:SUITE 140-341
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-1107
Mailing Address - Country:US
Mailing Address - Phone:360-870-0878
Mailing Address - Fax:866-354-3165
Practice Address - Street 1:422 CARPENTER RD SE
Practice Address - Street 2:SUITE # 104
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-7906
Practice Address - Country:US
Practice Address - Phone:360-870-0878
Practice Address - Fax:866-354-3165
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013615171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0162249OtherLABOR AND INDUSTRY