Healthcare Provider Details

I. General information

NPI: 1366948101
Provider Name (Legal Business Name): CHRISTINE ANNE NEARING LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE ANNE LEMMER LPTA

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 04/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 SW 37TH ST
PENDLETON OR
97801-3605
US

IV. Provider business mailing address

11281 NW KING AVE
PRINEVILLE OR
97754-8609
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-3374
  • Fax:
Mailing address:
  • Phone: 541-280-1357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number07845
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: