MEDICARE: MRS. CHRISTINE LEE KIRCHNER D.D.S.

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	122300000X	Dentist	8545	WA

General Provider Information

NPI Number	:	1710973607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE LEE KIRCHNER D.D.S.

Provider Business Mailing Address
First Line	:	6451 FAUNTLEROY WAY SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-1881
Country	:	US
Telephone Number	:	206-938-4540
Fax Number	:	206-935-1188

Provider Business Practice Location Address
First Line	:	6451 FAUNTLEROY WAY SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-1881
Country	:	US
Telephone Number	:	206-938-4540
Fax Number	:	206-935-1188

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	07/08/2007

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