Provider Demographics
NPI:1235293374
Name:FROST, CHRISTOPHER MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MARK
Last Name:FROST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2357
Mailing Address - Country:US
Mailing Address - Phone:360-293-6277
Mailing Address - Fax:360-299-2296
Practice Address - Street 1:1116 17TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2357
Practice Address - Country:US
Practice Address - Phone:360-293-6277
Practice Address - Fax:360-299-2296
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0171181OtherDEPARTMENT OF LABOR
WA2028728Medicaid
WA0171181OtherDEPARTMENT OF LABOR
WA2028728Medicaid