Provider Demographics
NPI:1366154759
Name:CHRISTENSEN, PAMELA MICHELLE (MA00018045)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:MICHELLE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MA00018045
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23209 109TH STREET CT E # NA
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-9770
Mailing Address - Country:US
Mailing Address - Phone:253-259-0419
Mailing Address - Fax:
Practice Address - Street 1:11216 SUNRISE BLVD E STE 3-203
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-8848
Practice Address - Country:US
Practice Address - Phone:253-259-0419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist