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General NPI Number Information
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NPI Number | 1679038129
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Entity Type | Individual
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Provider Name | MICAH PAUL CHRISTENSEN
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Gender | Male
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 2200 NW MYHRE RD
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City | SILVERDALE
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State | WA
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Zip | 98383-7681
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Country | US
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Telephone | 360-830-1321
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Fax | 360-830-1380
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Provider Business Mailing Address
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Address Line | 9621 RIDGETOP BLVD NW
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City | SILVERDALE
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State | WA
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Zip | 98383-8502
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Country | US
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Telephone | 360-782-3600
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Fax | 606-526-2901
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 007617
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT61013240
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License Number State | WA
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