Basic Information
| Provider Information | |||||||||
| NPI: | 1518957653 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHRISTEN | ||||||||
| FirstName: | BRUCE | ||||||||
| MiddleName: | ROBERT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2512 WHEATON WAY | ||||||||
| Address2: | |||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983103399 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 9621 RIDGETOP BLVD NW | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SILVERDALE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983838502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607823300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2005 | ||||||||
| LastUpdateDate: | 01/24/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 202C00000X | MD00028597 | WA | N | Allopathic & Osteopathic Physicians | Independent Medical Examiner | 2083X0100X | MD00028597 | WA | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
ID Information
| ID | Type | State | Issuer | Description | 7798169 | 01 | AETNA | OTHER | 229481 | 01 | WA | LABOR & INDUSTRIES IME | OTHER | FC0659992 | 01 | DEA | OTHER | 229366 | 01 | WA | LABOR & INDUSTRIES | OTHER | 6496CH | 01 | REGENCE | OTHER | 8514945 | 05 | WA | MEDICAID |