MEDICARE: CHRISTEEN DENEUI COA

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	156FX1101X	Ophthalmic Assistant

General Provider Information

NPI Number	:	1306401278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTEEN DENEUI COA

Provider Business Mailing Address
First Line	:	320 W GALER ST STE 201
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98119-3065
Country	:	US
Telephone Number	:	206-347-0821
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 W GALER ST STE 201
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98119-3065
Country	:	US
Telephone Number	:	206-347-0821
Fax Number	:

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

Provider Enumeration Date	:	05/07/2019
Last Update Date	:	06/14/2021

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Directions to “ CHRISTEEN DENEUI COA” Practice Location

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