Provider Demographics
NPI:1720452188
Name:SAFFORD, CHRISTINE MARIE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:SAFFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14913 SE MILL PLAIN BLVD
Mailing Address - Street 2:APT L73
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-8239
Mailing Address - Country:US
Mailing Address - Phone:360-713-3487
Mailing Address - Fax:
Practice Address - Street 1:14913 SE MILL PLAIN BLVD
Practice Address - Street 2:APT. L73
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-8239
Practice Address - Country:US
Practice Address - Phone:360-713-3487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00164449374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician