Provider Demographics
NPI:1568680577
Name:ROBINSON, CHRISTINE CAROLYN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:CAROLYN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1168
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:OR
Mailing Address - Zip Code:97535-1168
Mailing Address - Country:US
Mailing Address - Phone:541-535-3590
Mailing Address - Fax:541-535-1148
Practice Address - Street 1:721 N. MAIN ST.
Practice Address - Street 2:SPACE A
Practice Address - City:PHOENIX
Practice Address - State:OR
Practice Address - Zip Code:97535
Practice Address - Country:US
Practice Address - Phone:541-535-3590
Practice Address - Fax:541-535-1148
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU79589Medicare UPIN
ORR114092Medicare PIN