MEDICARE: HEATH CHRISTIANSON FNP-BC

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	363LF0000X	Family Nurse Practitioner	AP61008290	WA

General Provider Information

NPI Number	:	1508308966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATH CHRISTIANSON FNP-BC

Provider Business Mailing Address
First Line	:	807 LEWIS LN
Second Line	:
City	:	STEILACOOM
State	:	WA
Zip	:	98388-3705
Country	:	US
Telephone Number	:	719-287-4699
Fax Number	:

Provider Business Practice Location Address
First Line	:	2102 CARRIAGE ST SW STE H
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-1049
Country	:	US
Telephone Number	:	360-352-0711
Fax Number	:

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

Provider Enumeration Date	:	11/16/2016
Last Update Date	:	08/12/2025

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