Provider Demographics
NPI:1275057655
Name:CHOICE FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:CHOICE FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:509-876-9707
Mailing Address - Street 1:135 THORNE ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3142
Mailing Address - Country:US
Mailing Address - Phone:1509-529-5831
Mailing Address - Fax:509-955-1339
Practice Address - Street 1:135 THORNE ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3142
Practice Address - Country:US
Practice Address - Phone:509-876-9707
Practice Address - Fax:509-955-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty