Healthcare Provider Details

I. General information

NPI: 1336685031
Provider Name (Legal Business Name): EMMA JANE CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 NW 54TH ST SUITE 464
SEATTLE WA
98107-3570
US

IV. Provider business mailing address

9603 13TH AVE NW
SEATTLE WA
98117-2353
US

V. Phone/Fax

Practice location:
  • Phone: 503-506-8601
  • Fax:
Mailing address:
  • Phone: 503-506-8601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60468448
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License NumberMA60468448
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: