Provider Demographics
NPI:1275765810
Name:TAN, CHRISTOPHER BRYAN DANAQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER BRYAN
Middle Name:DANAQUE
Last Name:TAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3800 SUMMITVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2715
Mailing Address - Country:US
Mailing Address - Phone:509-248-6616
Mailing Address - Fax:509-225-2708
Practice Address - Street 1:3909 CREEKSIDE LOOP STE 120
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4880
Practice Address - Country:US
Practice Address - Phone:509-248-6616
Practice Address - Fax:509-225-2708
Is Sole Proprietor?:No
Enumeration Date:2009-08-16
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60614220207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology