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General NPI Number Information
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NPI Number | 1629118229
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Entity Type | Organization
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Legal Business Name | CHRISTIANSEN, LLC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 136 NE 3RD ST
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City | PRINEVILLE
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State | OR
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Zip | 97754-1915
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Country | US
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Telephone | 541-416-1970
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Fax | 541-416-1972
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Provider Business Mailing Address
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Address Line | 136 NE 3RD ST
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City | PRINEVILLE
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State | OR
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Zip | 97754-1915
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Country | US
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Telephone | 541-416-1970
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Fax | 541-416-1972
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Authorized Official
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Title or Position | OWNER
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Name | MR. HANS CRAIGEN CHRISTIANSEN
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Credential | RPH
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Telephone | 541-416-1970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RP-0001687-CS
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License Number State | OR
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