Healthcare Provider Details

I. General information

NPI: 1013481126
Provider Name (Legal Business Name): CHRISTINE MARIE HURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 STRANDER BLVD STE 105
TUKWILA WA
98188-2914
US

IV. Provider business mailing address

18235 131ST CT NE
BOTHELL WA
98011-3119
US

V. Phone/Fax

Practice location:
  • Phone: 206-313-8840
  • Fax:
Mailing address:
  • Phone: 206-799-0081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: