MEDICARE: ELAINE CHRISTENSEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist		UT

General Provider Information

NPI Number	:	1073476800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE CHRISTENSEN

Provider Business Mailing Address
First Line	:	1000 W BELLWOOD LN STE 1
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84123-4494
Country	:	US
Telephone Number	:	702-857-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 W BELLWOOD LN STE 1
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84123-4494
Country	:	US
Telephone Number	:	702-857-8800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ ELAINE CHRISTENSEN ” Practice Location

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