Provider Demographics
NPI:1497906986
Name:FRACZEK, CHRISTOPHER H (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:H
Last Name:FRACZEK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19120 SE 34TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-1430
Mailing Address - Country:US
Mailing Address - Phone:253-352-2480
Mailing Address - Fax:253-295-5594
Practice Address - Street 1:4105 TUDOR CENTRE DR
Practice Address - Street 2:100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5902
Practice Address - Country:US
Practice Address - Phone:907-565-4000
Practice Address - Fax:907-565-4011
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3272103TC0700X
AK576103TC0700X
WAPY61018950103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical