Healthcare Provider Details

I. General information

NPI: 1194405092
Provider Name (Legal Business Name): CHRISTINE BLYSTONE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE SHOEMAKER

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7109 GREENWOOD AVE N
SEATTLE WA
98103-5037
US

IV. Provider business mailing address

9127 MERRITT AVE SE
SNOQUALMIE WA
98065-5016
US

V. Phone/Fax

Practice location:
  • Phone: 206-782-8370
  • Fax:
Mailing address:
  • Phone: 425-417-5676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number61466289
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: