Healthcare Provider Details

I. General information

NPI: 1720553613
Provider Name (Legal Business Name): CHRISTINE EYLER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BELLEVUE PEDIATRICS, C & C MEDICAL ASSOCIATES 1940 116TH AVE NE, STE 200
BELLEVUE WA
98004
US

IV. Provider business mailing address

PO BOX 3379
FEDERAL WAY WA
98063-3379
US

V. Phone/Fax

Practice location:
  • Phone: 252-094-3314
  • Fax:
Mailing address:
  • Phone: 252-432-2934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAP60854654
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60854654
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: