Healthcare Provider Details

I. General information

NPI: 1831368117
Provider Name (Legal Business Name): CHRISTOPHER J OVERFIELD LMP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 BICKFORD AVE SUITE 209
SNOHOMISH WA
98290
US

IV. Provider business mailing address

13807 250TH AVE SE
MONROE WA
98272
US

V. Phone/Fax

Practice location:
  • Phone: 360-568-7774
  • Fax: 360-568-7779
Mailing address:
  • Phone: 425-260-2028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00024604
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: