Provider Demographics
NPI:1730432998
Name:DAVIDSON, CHRISTINE A (RD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N 85TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3701
Mailing Address - Country:US
Mailing Address - Phone:206-782-8660
Mailing Address - Fax:206-782-8765
Practice Address - Street 1:905 SPRUCE ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2474
Practice Address - Country:US
Practice Address - Phone:206-548-3114
Practice Address - Fax:206-762-6355
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60259553133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered