Provider Demographics
NPI:1164604849
Name:WALTERS, CHRISTOPHER JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:WALTERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15811 AMBAUM BLVD SW
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166
Mailing Address - Country:US
Mailing Address - Phone:206-242-8211
Mailing Address - Fax:206-242-0162
Practice Address - Street 1:15811 AMBAUM BLVD SW
Practice Address - Street 2:SUITE 110
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3066
Practice Address - Country:US
Practice Address - Phone:206-242-8211
Practice Address - Fax:206-242-0162
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0274108OtherLABOR & INDUSTRIES
WA0226133OtherLABOR & INDUSTRIES