1073237434 NPI number — DR. CHRISTINA SUZANA CRESS PSYD

Table of content: MS. CATHRYN AGNES ROBINSON CRNA/ARNP (NPI 1346240975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073237434 NPI number — DR. CHRISTINA SUZANA CRESS PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRESS
Provider First Name:
CHRISTINA
Provider Middle Name:
SUZANA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DE LA PENA
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
SUZANA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1073237434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25608
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84125-0608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37624 SE FURY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SNOQUALMIE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98065-9680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-888-2016
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/29/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  61240628 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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