Provider Demographics
NPI:1255661765
Name:JAMES, CHRIS A
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:A
Last Name:JAMES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4639 COMMERCIAL ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1901
Mailing Address - Country:US
Mailing Address - Phone:503-566-5555
Mailing Address - Fax:503-566-3420
Practice Address - Street 1:4639 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1901
Practice Address - Country:US
Practice Address - Phone:503-566-5555
Practice Address - Fax:503-566-3420
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-10114265174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist