Provider Demographics
NPI:1649316928
Name:KORSGAARD, CHRISTOPHER PATRICK (ARNP)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:PATRICK
Last Name:KORSGAARD
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S ARTHUR ST STE 670
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2220
Mailing Address - Country:US
Mailing Address - Phone:509-389-5794
Mailing Address - Fax:509-535-4593
Practice Address - Street 1:140 S ARTHUR ST STE 670
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2220
Practice Address - Country:US
Practice Address - Phone:509-389-5794
Practice Address - Fax:509-535-4593
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007598363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8865972Medicare PIN