Provider Demographics
NPI:1568633618
Name:CARR, CHRISTOPHER SEAN (LMP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SEAN
Last Name:CARR
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 SE CHKALOV DR STE 1
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5275
Mailing Address - Country:US
Mailing Address - Phone:360-604-8006
Mailing Address - Fax:
Practice Address - Street 1:808 SE CHKALOV DR STE 1
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5275
Practice Address - Country:US
Practice Address - Phone:360-604-8006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist