Provider Demographics
NPI:1831793348
Name:DAMBACHER, CHRISTINA (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DAMBACHER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 STELLAR DR
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-7921
Mailing Address - Country:US
Mailing Address - Phone:907-690-2276
Mailing Address - Fax:
Practice Address - Street 1:1543 STELLAR DR
Practice Address - Street 2:
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-7921
Practice Address - Country:US
Practice Address - Phone:907-690-2276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK158522225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty