Basic Information
Provider Information
NPI: 1528384906
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAYES
FirstName: CHRISTINE
MiddleName: Y
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: YAO
OtherFirstName: CHRISTINE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: D.O.
OtherLastNameType: 5
Mailing Information
Address1: 9040 JACKSON AVE
Address2:  
City: TACOMA
State: WA
PostalCode: 984310001
CountryCode: US
TelephoneNumber: 2539682252
FaxNumber: 2539683278
Practice Location
Address1: 9040 JACKSON AVE
Address2:  
City: TACOMA
State: WA
PostalCode: 984310001
CountryCode: US
TelephoneNumber: 2539682252
FaxNumber: 2539683278
Other Information
ProviderEnumerationDate: 04/11/2010
LastUpdateDate: 06/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X876NEN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XOP60698045WAN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XOP60698045WAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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