Provider Demographics
NPI:1457303091
Name:LENTZ, CHRISTINE J (PT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:J
Last Name:LENTZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:J
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4049 SE ANKENY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2013
Mailing Address - Country:US
Mailing Address - Phone:503-236-6540
Mailing Address - Fax:
Practice Address - Street 1:9828 E BURNSIDE ST
Practice Address - Street 2:SUITE 250
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2354
Practice Address - Country:US
Practice Address - Phone:503-254-3424
Practice Address - Fax:503-254-3635
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist