Basic Information
| Provider Information | |||||||||
| NPI: | 1023098860 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHRIST | ||||||||
| FirstName: | CONSTANCE | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3649 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992203649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098382531 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 610 S SHERMAN ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992021342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098382531 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 01/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 0101222253 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | MD60202978 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 227154 | 01 | VA | SOUTHERN HEALTH | OTHER | 72648 | 01 | VA | COMMUNITY HEALTH | OTHER | 101799 | 05 | VA | MEDICAID | 1023098860 | 05 | WA | MEDICAID | 101799 | 01 | VA | ANTHEM SVC HEALTHKEEPERS | OTHER | 010022797 | 05 | VA | MEDICAID | 72648 | 05 | VA | MEDICAID | 2115530 | 01 | VA | MAMSI | OTHER | 4044574 | 01 | VA | CIGNA | OTHER |