Provider Demographics
NPI:1164174082
Name:CHILDS, CHANDLER CHRISTINE MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:CHRISTINE MARIE
Last Name:CHILDS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CHANDLER
Other - Middle Name:CHRISTINE MARIE
Other - Last Name:PFAFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1156 S CEDAR PL
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-5315
Mailing Address - Country:US
Mailing Address - Phone:509-592-3511
Mailing Address - Fax:
Practice Address - Street 1:1000 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5533
Practice Address - Country:US
Practice Address - Phone:509-222-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61029693225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist