Provider Demographics
NPI:1013433960
Name:NOEL, CHRISTINE SUSAN (LMT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:SUSAN
Last Name:NOEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E DIMOND BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2048
Mailing Address - Country:US
Mailing Address - Phone:907-830-9825
Mailing Address - Fax:
Practice Address - Street 1:3823 SPENARD RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2678
Practice Address - Country:US
Practice Address - Phone:907-677-1600
Practice Address - Fax:907-677-2779
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
AK107656225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist