Basic Information
Provider Information
NPI: 1285197434
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KIRSCHMAN
FirstName: CHRISTY
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DOBBS
OtherFirstName: CHRISTY
OtherMiddleName: ANN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 7440 W MARGINAL WAY S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981084141
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1960 THOMPSON DR
Address2:  
City: SEDRO WOOLLEY
State: WA
PostalCode: 982845007
CountryCode: US
TelephoneNumber: 3608563186
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/12/2019
LastUpdateDate: 04/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN00131605WAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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