MEDICARE: ANN CHRISTIANSEN LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LW61453218	WA

General Provider Information

NPI Number	:	1013712181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN CHRISTIANSEN LICSW

Provider Business Mailing Address
First Line	:	19913 145TH ST E
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-6180
Country	:	US
Telephone Number	:	360-908-8475
Fax Number	:

Provider Business Practice Location Address
First Line	:	19913 145TH ST E
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-6180
Country	:	US
Telephone Number	:	360-908-8475
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2025
Last Update Date	:	02/13/2025

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Directions to “ ANN CHRISTIANSEN LICSW” Practice Location

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