MEDICARE: MRS. CHRISTINA BRAATEN LMP

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	171W00000X	Contractor	MA60361569	WA

General Provider Information

NPI Number	:	1396183554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINA BRAATEN LMP

Provider Business Mailing Address
First Line	:	1427 N MONROE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2624
Country	:	US
Telephone Number	:	509-328-3285
Fax Number	:

Provider Business Practice Location Address
First Line	:	1427 N MONROE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2624
Country	:	US
Telephone Number	:	509-328-3285
Fax Number	:

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

Provider Enumeration Date	:	06/10/2013
Last Update Date	:	06/10/2013

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