Provider Demographics
NPI:1477717486
Name:WALKER, CHRISTINA J (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:WALKER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:J
Other - Last Name:WALKER-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:1930 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2303
Mailing Address - Country:US
Mailing Address - Phone:503-724-2790
Mailing Address - Fax:
Practice Address - Street 1:1930 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2303
Practice Address - Country:US
Practice Address - Phone:503-724-2790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01159171100000X
OH286171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist