Provider Demographics
NPI:1831153030
Name:BUCHANAN, CHRISTINE SWEENEY (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SWEENEY
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34004 16TH AVE S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8903
Mailing Address - Country:US
Mailing Address - Phone:253-312-0883
Mailing Address - Fax:253-719-8128
Practice Address - Street 1:34004 16TH AVE S
Practice Address - Street 2:SUITE 101
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8903
Practice Address - Country:US
Practice Address - Phone:253-312-0883
Practice Address - Fax:253-719-8128
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003845235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2769BUOtherREGENCE BLUESHIELD PIN