Provider Demographics
NPI:1073231668
Name:GRAHAM, CHRISTOPHER STEVEN
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:STEVEN
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41625 MOUNTAIN VIEW PL E
Mailing Address - Street 2:
Mailing Address - City:GOLD BAR
Mailing Address - State:WA
Mailing Address - Zip Code:98251-9208
Mailing Address - Country:US
Mailing Address - Phone:360-631-9987
Mailing Address - Fax:
Practice Address - Street 1:41625 MOUNTAIN VIEW PL E
Practice Address - Street 2:
Practice Address - City:GOLD BAR
Practice Address - State:WA
Practice Address - Zip Code:98251-9208
Practice Address - Country:US
Practice Address - Phone:360-631-9987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician