Individual
WADE K CHRISTENSEN
Active
Individual
WADE K CHRISTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA268
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010017817
BLUE SHIELD INDIVIUAL
ID
01
—
000010027582
REGENCE BLUESHIELD GROUP
ID
01
—
1134140148
BAKER FAMILY PRACT NPI
ID
05
—
805622400
—
ID
05
—
807659300
—
ID
05
—
807937700
—
ID
01
—
8K123
BLUE CROSS GROUP
ID
01
—
DE1614
RAILROAD MCR GROUP
ID
01
—
P00275624
RAILROAD MEDICARE
ID
01
—
PALR9
BLUE CROSS PROVIDER NUMBE
ID
Enumeration date
11/15/2005
Last updated
07/19/2010
Update your record
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