Provider Demographics
NPI:1467438325
Name:TADLOCK, CHRISTOPHER PAUL (HEALTH SERVICES TECH)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:TADLOCK
Suffix:
Gender:M
Credentials:HEALTH SERVICES TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 152ND AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-3208
Mailing Address - Country:US
Mailing Address - Phone:253-891-1838
Mailing Address - Fax:
Practice Address - Street 1:COMDT (CG-1122), U.S. COAST GUARD
Practice Address - Street 2:2100 2ND ST SW, SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:206-217-6290
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information