Healthcare Provider Details

I. General information

NPI: 1194389775
Provider Name (Legal Business Name): CHRISTIAN JANEE' GRAVES FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 HARBORVIEW DR
GIG HARBOR WA
98332-2100
US

IV. Provider business mailing address

3417 HARBORVIEW DR
GIG HARBOR WA
98332-2100
US

V. Phone/Fax

Practice location:
  • Phone: 206-333-8713
  • Fax:
Mailing address:
  • Phone: 330-209-8309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61561791
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: