Provider Demographics
NPI:1073589172
Name:CHAPMAN, CHRIS ROBERT (LD)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:ROBERT
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:LD
Other - Prefix:MR
Other - First Name:CHRIS
Other - Middle Name:ROBERT
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LD
Mailing Address - Street 1:926 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1538
Mailing Address - Country:US
Mailing Address - Phone:541-386-2012
Mailing Address - Fax:541-387-5500
Practice Address - Street 1:926 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1538
Practice Address - Country:US
Practice Address - Phone:541-386-2012
Practice Address - Fax:541-387-5500
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDT-DO-663650122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORDT-DO-663650OtherSTATE LICENSE NUMBER