Provider Demographics
NPI:1215175831
Name:KING, CHRISTINE LYNN (LICENSED DISPENSING)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYNN
Last Name:KING
Suffix:
Gender:F
Credentials:LICENSED DISPENSING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 920323
Mailing Address - Street 2:
Mailing Address - City:DUTCH HARBOR
Mailing Address - State:AK
Mailing Address - Zip Code:99692-0323
Mailing Address - Country:US
Mailing Address - Phone:907-359-4225
Mailing Address - Fax:
Practice Address - Street 1:31 THOMPSON CIRCLE
Practice Address - Street 2:
Practice Address - City:UNALASKA
Practice Address - State:AK
Practice Address - Zip Code:99685-9968
Practice Address - Country:US
Practice Address - Phone:907-359-4225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK167948156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician