Healthcare Provider Details

I. General information

NPI: 1609539311
Provider Name (Legal Business Name): CHRISTINA LEIGH KNUDSEN LW-61290410
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W MAIN AVE STE 307
SPOKANE WA
99201-0119
US

IV. Provider business mailing address

PO BOX 8241
SPOKANE WA
99203-0241
US

V. Phone/Fax

Practice location:
  • Phone: 509-262-5516
  • Fax: 509-214-0157
Mailing address:
  • Phone: 509-262-5516
  • Fax: 509-214-0157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW-61290410
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: