Provider Demographics
NPI:1376936989
Name:MCKAY, CHRISTINE (LMP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MCKAY
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:PO BOX 2374
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98073-2374
Mailing Address - Country:US
Mailing Address - Phone:224-578-4122
Mailing Address - Fax:
Practice Address - Street 1:17609 NE 88TH PL
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3252
Practice Address - Country:US
Practice Address - Phone:224-578-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-07
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016305172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker