Provider Demographics
NPI:1689757593
Name:GARNER, CHRISTINA M (DPT, PT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:GARNER
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 W LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-5472
Mailing Address - Country:US
Mailing Address - Phone:509-543-6703
Mailing Address - Fax:509-543-6706
Practice Address - Street 1:1215 W LEWIS ST
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-5472
Practice Address - Country:US
Practice Address - Phone:509-543-6703
Practice Address - Fax:509-543-6706
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010224225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA223868516OtherMOLINA
WA650024633OtherRAIL ROAD MEDICARE
WA7157842OtherAETNA
WA0212197OtherL AND I