Provider Demographics
NPI:1508308966
Name:CHRISTIANSON, HEATH (FNP-BC)
Entity type:Individual
Prefix:
First Name:HEATH
Middle Name:
Last Name:CHRISTIANSON
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 LEWIS LN
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-3705
Mailing Address - Country:US
Mailing Address - Phone:719-287-4699
Mailing Address - Fax:
Practice Address - Street 1:2102 CARRIAGE ST SW STE H
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1049
Practice Address - Country:US
Practice Address - Phone:360-352-0711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61008290363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily