Provider Demographics
NPI:1861565038
Name:WAINWRIGHT, NIA CHRISTINE (LMP)
Entity type:Individual
Prefix:MRS
First Name:NIA
Middle Name:CHRISTINE
Last Name:WAINWRIGHT
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 1:3610 GRANDVIEW ST STE A
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1135
Mailing Address - Country:US
Mailing Address - Phone:253-853-1900
Mailing Address - Fax:253-853-1808
Practice Address - Street 1:3610 GRANDVIEW ST STE A
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1135
Practice Address - Country:US
Practice Address - Phone:253-853-1900
Practice Address - Fax:253-853-1808
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011219174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist