Provider Demographics
NPI:1457651549
Name:RAUNIG, CHRISTINA MARIE (LAC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:RAUNIG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5244 SW COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1188
Mailing Address - Country:US
Mailing Address - Phone:541-754-1717
Mailing Address - Fax:
Practice Address - Street 1:845 NW MONROE AVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6352
Practice Address - Country:US
Practice Address - Phone:541-754-1717
Practice Address - Fax:541-200-6020
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-24
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC150780171100000X
WAAC 60140569171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist