Provider Demographics
NPI:1922408384
Name:CHAPLIN, CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CHAPLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 SE 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-3444
Mailing Address - Country:US
Mailing Address - Phone:971-209-2335
Mailing Address - Fax:503-420-5322
Practice Address - Street 1:4016 SE 72ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-3444
Practice Address - Country:US
Practice Address - Phone:971-209-2335
Practice Address - Fax:503-420-5322
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL78481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR15516645OtherCAQH
OR1922408384OtherNPPES
OR500677253Medicaid
ORL7848OtherOREGON BLSW