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General NPI Number Information
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NPI Number | 1083861199
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Entity Type | Individual
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Provider Name | MATTHEW ALAN CHRISTIANSON
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Gender | Male
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 16233 SYLVESTER RD SW SUITE 110
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City | BURIEN
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State | WA
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Zip | 98166
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Country | US
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Telephone | 206-988-5785
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Fax | 206-901-8414
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Provider Business Mailing Address
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Address Line | 3163 SE 4TH ST
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City | RENTON
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State | WA
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Zip | 98056
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Country | US
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Telephone | 425-235-7430
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 00041022
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License Number State | WA
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