Healthcare Provider Details

I. General information

NPI: 1861223992
Provider Name (Legal Business Name): MCKAY CHRISTENSEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2024
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S 20TH AVE
SAFFORD AZ
85546-4011
US

IV. Provider business mailing address

921 S. 8TH AVE. STOP 8253
POCATELLO ID
83209
US

V. Phone/Fax

Practice location:
  • Phone: 928-348-4000
  • Fax:
Mailing address:
  • Phone: 208-282-4726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: