Provider Demographics
NPI:1063753846
Name:DAVIDSON-JUHNKE, CHRISTEN L (PT)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:L
Last Name:DAVIDSON-JUHNKE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 HAVSTAD DR
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-9235
Mailing Address - Country:US
Mailing Address - Phone:509-876-2203
Mailing Address - Fax:
Practice Address - Street 1:1384 HAVSTAD DR
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-9235
Practice Address - Country:US
Practice Address - Phone:509-876-2203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000083732251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics