Provider Demographics
NPI:1194034595
Name:INMAN, CHRISTINA NOEL (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:NOEL
Last Name:INMAN
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:NOEL
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, ATC
Mailing Address - Street 1:805 SW INDUSTRIAL WAY
Mailing Address - Street 2:STE 3
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1093
Mailing Address - Country:US
Mailing Address - Phone:541-585-2529
Mailing Address - Fax:541-585-2536
Practice Address - Street 1:1160 SW SIMPSON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3542
Practice Address - Country:US
Practice Address - Phone:541-322-9045
Practice Address - Fax:541-322-9044
Is Sole Proprietor?:No
Enumeration Date:2010-10-02
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61047225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500688632Medicaid
ORR182735Medicare PIN