Provider Demographics
NPI:1396995494
Name:O'CONNOR-PERRINO, CHRISTINE PAIGE (LMP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:PAIGE
Last Name:O'CONNOR-PERRINO
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 1:172 THORNTON DR
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-8060
Mailing Address - Country:US
Mailing Address - Phone:360-808-6429
Mailing Address - Fax:
Practice Address - Street 1:172 THORNTON DR
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-8060
Practice Address - Country:US
Practice Address - Phone:360-808-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60046382225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist