Provider Demographics
NPI:1831368117
Name:OVERFIELD, CHRISTOPHER J (LMP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:OVERFIELD
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13807 250TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272
Mailing Address - Country:US
Mailing Address - Phone:425-260-2028
Mailing Address - Fax:
Practice Address - Street 1:1830 BICKFORD AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290
Practice Address - Country:US
Practice Address - Phone:360-568-7774
Practice Address - Fax:360-568-7779
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024604225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0021OVOtherREGENCE
WA0022OVOtherREGENCE
WA0269578OtherDEPT L&I
WA0229622OtherDEPT L&I
WA0025OVOtherREGENCE
WA0026OVOtherREGENCE
WA0023OVOtherREGENCE
WA0024OVOtherREGENCE
WA0027OVOtherREGENCE