Healthcare Provider Details

I. General information

NPI: 1235076324
Provider Name (Legal Business Name): CHRISTINA DOMBAL RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1201 100TH ST NE
GRANITE FALLS WA
98252-8632
US

IV. Provider business mailing address

1201 100TH ST NE
GRANITE FALLS WA
98252-8632
US

V. Phone/Fax

Practice location:
  • Phone: 360-283-4388
  • Fax: 425-412-8493
Mailing address:
  • Phone: 360-283-4388
  • Fax: 425-412-8493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.RN.61508048
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: