Healthcare Provider Details

I. General information

NPI: 1356719215
Provider Name (Legal Business Name): CHRISTINA MESSAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 116TH AVE NE SUITE 101
BELLEVUE WA
98004-3010
US

IV. Provider business mailing address

4220 132ND ST SE SUITE 101
MILL CREEK WA
98012-8999
US

V. Phone/Fax

Practice location:
  • Phone: 425-628-2072
  • Fax: 425-341-9056
Mailing address:
  • Phone: 425-316-8046
  • Fax: 425-338-9637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60560449
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: