Provider Demographics
NPI:1013251008
Name:GRENINGER, CHRISTOPHER WAYNE (LMP)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:WAYNE
Last Name:GRENINGER
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:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-8140
Mailing Address - Country:US
Mailing Address - Phone:360-423-0203
Mailing Address - Fax:360-577-0187
Practice Address - Street 1:2700 SIMPSON AVE STE 1010
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-4335
Practice Address - Country:US
Practice Address - Phone:360-612-0012
Practice Address - Fax:360-352-0670
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG61485099175T00000X, 101Y00000X
WAMA 60240938225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No175T00000XOther Service ProvidersPeer Specialist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist