Provider Demographics
NPI:1265604201
Name:PITTS, CHRISTINE ALLISON (LMP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ALLISON
Last Name:PITTS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:ALLISON
Other - Last Name:HAMMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1283 S ELGER BAY RD
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-8375
Mailing Address - Country:US
Mailing Address - Phone:360-387-4502
Mailing Address - Fax:
Practice Address - Street 1:1283 ELGER BAY RD
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-8375
Practice Address - Country:US
Practice Address - Phone:360-387-4502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024034171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor