Healthcare Provider Details

I. General information

NPI: 1952243776
Provider Name (Legal Business Name): CHRISTINE MESQUITA KHANNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6912 220TH ST SW STE 202
MOUNTLAKE TERRACE WA
98043-2171
US

IV. Provider business mailing address

6912 220TH ST SW STE 202
MOUNTLAKE TERRACE WA
98043-2171
US

V. Phone/Fax

Practice location:
  • Phone: 425-403-5765
  • Fax:
Mailing address:
  • Phone: 425-403-5765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: