Provider Demographics
NPI:1013184936
Name:STRODE, CHRISTINA RAINWATER (LMP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:RAINWATER
Last Name:STRODE
Suffix:
Gender:F
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:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:WA
Mailing Address - Zip Code:98353-0220
Mailing Address - Country:US
Mailing Address - Phone:360-271-8389
Mailing Address - Fax:360-871-6382
Practice Address - Street 1:2427 BETHEL RD SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2438
Practice Address - Country:US
Practice Address - Phone:360-271-8389
Practice Address - Fax:360-874-7952
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013613225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist