Provider Demographics
NPI:1275848392
Name:LUTHER, CHRISTINE CARPENTER
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CARPENTER
Last Name:LUTHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:LUTHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, BS, PCS
Mailing Address - Street 1:113 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3519
Mailing Address - Country:US
Mailing Address - Phone:503-263-8903
Mailing Address - Fax:503-266-8632
Practice Address - Street 1:27501 SW 95TH AVE STE 960
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-7713
Practice Address - Country:US
Practice Address - Phone:503-855-3223
Practice Address - Fax:503-266-8632
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT97622251P0200X
OR60822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics