Provider Demographics
NPI:1942566013
Name:NIMMO, CHRISTOPHER LEE (LMP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:NIMMO
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 1:15254 SUNWOOD BLVD
Mailing Address - Street 2:E-22
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-7853
Mailing Address - Country:US
Mailing Address - Phone:206-747-4420
Mailing Address - Fax:
Practice Address - Street 1:15254 SUNWOOD BLVD
Practice Address - Street 2:E-22
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-7853
Practice Address - Country:US
Practice Address - Phone:206-747-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60270852225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist