Provider Demographics
NPI:1871745877
Name:MONROE, CHRISTINE LEE (LMP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LEE
Last Name:MONROE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 5TH ST # 1
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4737
Mailing Address - Country:US
Mailing Address - Phone:425-501-3954
Mailing Address - Fax:360-659-3555
Practice Address - Street 1:1518 5TH ST # 1
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4737
Practice Address - Country:US
Practice Address - Phone:425-501-3954
Practice Address - Fax:360-659-3555
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023950225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist