Healthcare Provider Details

I. General information

NPI: 1932460078
Provider Name (Legal Business Name): DAVID CHRISTOPHER FREE DNP, FNP-C, ACHPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 BRIDGE ST
CLARKSTON WA
99403-2332
US

IV. Provider business mailing address

1370 BRIDGE ST
CLARKSTON WA
99403-2332
US

V. Phone/Fax

Practice location:
  • Phone: 888-253-6598
  • Fax:
Mailing address:
  • Phone: 888-253-6598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5009092
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9471296
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337484
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61552417
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR187459
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberAPRN9471296
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: