Provider Demographics
NPI:1063249167
Name:ERFAN, CHRISTINA CAROL (MA-P)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:CAROL
Last Name:ERFAN
Suffix:
Gender:F
Credentials:MA-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6882 43RD ST NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-5031
Mailing Address - Country:US
Mailing Address - Phone:360-788-3415
Mailing Address - Fax:
Practice Address - Street 1:6882 43RD ST NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-5031
Practice Address - Country:US
Practice Address - Phone:360-788-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAN24108273202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology