Provider Demographics
NPI:1487438099
Name:STEPHENS, CHRISTINA SPRING (ND)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:SPRING
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:SPRING
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:2621 WILDERNESS DR SE UNIT B
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4328
Mailing Address - Country:US
Mailing Address - Phone:503-807-4190
Mailing Address - Fax:
Practice Address - Street 1:2621 WILDERNESS DR SE UNIT B
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-4328
Practice Address - Country:US
Practice Address - Phone:503-807-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61193801175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath