Basic Information
Provider Information
NPI: 1881020246
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHRISTIANSEN
FirstName: JULIE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: PMHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 N IRON BRIDGE WAY
Address2:  
City: SPOKANE
State: WA
PostalCode: 992024932
CountryCode: US
TelephoneNumber: 5094448888
FaxNumber:  
Practice Location
Address1: 401 S MAIN ST
Address2:  
City: DEER PARK
State: WA
PostalCode: 990068238
CountryCode: US
TelephoneNumber: 5094448200
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/17/2013
LastUpdateDate: 01/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN00165549WAN Nursing Service ProvidersRegistered Nurse 
363LP0808XAP60834536WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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