Provider Demographics
NPI:1578302527
Name:SEXTON, CHRISTOPHER TATE (PA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TATE
Last Name:SEXTON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 CAPITAL MALL DR SW STE 200
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8701
Mailing Address - Country:US
Mailing Address - Phone:360-706-6400
Mailing Address - Fax:
Practice Address - Street 1:3920 CAPITAL MALL DR SW STE 200
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8701
Practice Address - Country:US
Practice Address - Phone:360-706-6400
Practice Address - Fax:360-596-4889
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
WAPA61604447363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical