Provider Demographics
NPI:1669579363
Name:HARVEY, CHRISTINE MAYER (PT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MAYER
Last Name:HARVEY
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 1:24609 156TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4143
Mailing Address - Country:US
Mailing Address - Phone:253-630-0469
Mailing Address - Fax:
Practice Address - Street 1:24020 132ND AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-5108
Practice Address - Country:US
Practice Address - Phone:253-631-1933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT3181225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8353088Medicaid
WAHA9052OtherREGENCE
WA0049497OtherL&I
WAP00060734OtherRAILROAD MEDICARE
WA8353088Medicaid
WAGAB38791Medicare ID - Type Unspecified