Provider Demographics
NPI:1245664754
Name:RANKIN, CHRISTINE SUE (QMHA)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:SUE
Last Name:RANKIN
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 STELLERS EAGLE ST NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-4270
Mailing Address - Country:US
Mailing Address - Phone:503-428-3479
Mailing Address - Fax:
Practice Address - Street 1:444 STELLERS EAGLE ST NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-4270
Practice Address - Country:US
Practice Address - Phone:503-428-3479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst