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General NPI Number Information
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NPI Number | 1770017709
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Entity Type | Individual
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Provider Name | SEAN MICHAEL CHRISTIANSEN RPH
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Gender | Male
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 1308 N 20TH AVE
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City | PASCO
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State | WA
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Zip | 99301-4054
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Country | US
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Telephone | 509-545-9581
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 S KENT ST
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City | KENNEWICK
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State | WA
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Zip | 99337-4124
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Country | US
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Telephone | 801-608-9228
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 60700908
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License Number State | WA
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