| NPI | 1538282504 |
|---|---|
| Former Name | ILA NICOLE CHRISTIANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60688882) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: AK 192) |
| 133V00000X Dietitian, Registered (Licence: WA DI 60680930) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2019-07-29 |