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General NPI Number Information
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NPI Number | 1124109608
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Entity Type | Individual
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Provider Name | STEPHEN L. CHRISTENSEN O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 05/12/2015
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Provider Practice Location Address
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Address Line | 1321 N COLUMBIA CENTER BLVD STE 419
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City | KENNEWICK
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State | WA
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Zip | 99336-2455
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Country | US
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Telephone | 480-861-7331
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Fax | 480-755-3534
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Provider Business Mailing Address
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Address Line | 3911 S LINCOLN ST
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City | KENNEWICK
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State | WA
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Zip | 99338-9230
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Country | US
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Telephone | 480-861-7331
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Fax | 480-755-3534
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 037
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License Number State | AZ
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