Provider Demographics
NPI:1982071957
Name:DONOHUE, CHRISTOPHER ROBERT
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:DONOHUE
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 1:4207 W NOTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205
Mailing Address - Country:US
Mailing Address - Phone:509-995-2923
Mailing Address - Fax:
Practice Address - Street 1:9720 N NEVADA ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-3412
Practice Address - Country:US
Practice Address - Phone:509-464-2273
Practice Address - Fax:509-242-1854
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60581758225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60581758OtherSTATE LICENSE