Provider Demographics
NPI:1700590684
Name:MEADORS, LANDON CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:LANDON
Middle Name:CHRISTOPHER
Last Name:MEADORS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 N OAK HARBOR ST APT 203
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3547
Mailing Address - Country:US
Mailing Address - Phone:317-987-5272
Mailing Address - Fax:
Practice Address - Street 1:1040 SW KIMBALL DR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-7593
Practice Address - Country:US
Practice Address - Phone:360-279-0933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker