Provider Demographics
NPI:1689067001
Name:LEWIS, CHRISTINE SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:SUE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:SUE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4304 OCEAN BEACH HWY
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-4826
Mailing Address - Country:US
Mailing Address - Phone:360-562-2002
Mailing Address - Fax:
Practice Address - Street 1:1815 HUDSON ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2913
Practice Address - Country:US
Practice Address - Phone:360-562-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5624111N00000X
WA60963128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor