1699911222 NPI number — COLTON/CHRISTIANSEN PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699911222 NPI number — COLTON/CHRISTIANSEN PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLTON/CHRISTIANSEN PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PLAZA 410 DENTAL ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699911222
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16202 64TH ST E
Provider Second Line Business Mailing Address:
SUITE #101
Provider Business Mailing Address City Name:
SUMNER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98390-3028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-891-0977
Provider Business Mailing Address Fax Number:
253-826-4613

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16202 64TH ST E
Provider Second Line Business Practice Location Address:
SUITE #101
Provider Business Practice Location Address City Name:
SUMNER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98390-3028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-891-0977
Provider Business Practice Location Address Fax Number:
253-826-4613
Provider Enumeration Date:
01/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
COLTON
Authorized Official First Name:
D
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
253-891-0977

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  5404 , 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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