Provider Demographics
NPI:1700625191
Name:CHRISTIANSEN, HOUSTON STEVEN (DMD)
Entity type:Individual
Prefix:DR
First Name:HOUSTON
Middle Name:STEVEN
Last Name:CHRISTIANSEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4436 HIBISCUS CIR SW
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-8818
Mailing Address - Country:US
Mailing Address - Phone:801-557-0219
Mailing Address - Fax:
Practice Address - Street 1:2472 BETHEL RD SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2404
Practice Address - Country:US
Practice Address - Phone:360-329-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA615461891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice