Healthcare Provider Details

I. General information

NPI: 1962797803
Provider Name (Legal Business Name): CHRISTINE SHARON HUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12405 SW MAIN ST
TIGARD OR
97223-6109
US

IV. Provider business mailing address

15815 SW REDSTONE DR
BEAVERTON OR
97007-6351
US

V. Phone/Fax

Practice location:
  • Phone: 503-620-4880
  • Fax:
Mailing address:
  • Phone: 503-550-9570
  • Fax: 971-327-6710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18047
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: