Individual
JAMES TYLER CHRISTENSEN
Active
Individual
JAMES TYLER CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-402
ID
363AM0700X
Medical Physician Assistant
Primary
PA402
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806420100
—
ID
01
—
PASQ2
BLUE CROSS
ID
Enumeration date
12/30/2005
Last updated
05/28/2010
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