Provider Demographics
NPI:1912794033
Name:DERIG, CHRISTIN DIANE (AGPCNP)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:DIANE
Last Name:DERIG
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:DIANE
Other - Last Name:JACOBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7315 27TH ST W STE 5
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4608
Mailing Address - Country:US
Mailing Address - Phone:253-312-2934
Mailing Address - Fax:
Practice Address - Street 1:5801 SOUNDVIEW DR STE 150
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2215
Practice Address - Country:US
Practice Address - Phone:253-312-2934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00156954363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner