=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770704124
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANA SUE CHRISTNER MS,PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1010 S 336TH ST
-----------------------------------------------------
City | FEDERAL WAY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98003-6385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-835-5769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21512 40TH AVE W
-----------------------------------------------------
City | MOUNTLAKE TERRACE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98043-3581
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-210-9361
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT00008438
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------