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General NPI Number Information
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NPI Number | 1780731786
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE RUST DPT, PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 302 S 1ST AVE
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City | SANDPOINT
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State | ID
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Zip | 83864-1258
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Country | US
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Telephone | 208-263-5109
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Fax |
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Provider Business Mailing Address
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Address Line | 14 ROSS RD
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City | SANDPOINT
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State | ID
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Zip | 83864-6366
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Country | US
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Telephone | 208-290-2856
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Fax | 208-290-2856
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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 | PT00007582
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License Number State | WA
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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 | PT-1097
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | RPT-1097
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT63869
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60896309
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA190463
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License Number State | OR
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Taxonomy #7
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-1994
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License Number State | ID
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