Healthcare Provider Details

I. General information

NPI: 1790159309
Provider Name (Legal Business Name): CHRISTOPHER S BARKER MSW, CSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 02/26/2024
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 WAITE ST STE 1
NORTH BEND OR
97459-1229
US

IV. Provider business mailing address

1300 N BAYSHORE DR STE 202
COOS BAY OR
97420-2526
US

V. Phone/Fax

Practice location:
  • Phone: 541-756-6232
  • Fax:
Mailing address:
  • Phone: 541-756-6232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberA14574
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: