Healthcare Provider Details

I. General information

NPI: 1871008532
Provider Name (Legal Business Name): CHRISTY MCCLAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 12/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10413 BEARDSLEE BLVD
BOTHELL WA
98011-3463
US

IV. Provider business mailing address

10413 BEARDSLEE BLVD
BOTHELL WA
98011-3463
US

V. Phone/Fax

Practice location:
  • Phone: 425-485-6403
  • Fax:
Mailing address:
  • Phone: 425-485-6403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number438
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: