Provider Demographics
NPI:1780723635
Name:CARLSON, CHRISTINE ELIZABETH (ARNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:CARLSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 4TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-2611
Mailing Address - Country:US
Mailing Address - Phone:206-915-2256
Mailing Address - Fax:206-281-2674
Practice Address - Street 1:3307 3RD AVE W
Practice Address - Street 2:110
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-1940
Practice Address - Country:US
Practice Address - Phone:206-281-2231
Practice Address - Fax:206-281-2674
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005657363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care