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General NPI Number Information
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NPI Number | 1407122641
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Entity Type | Individual
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Provider Name | CHRISTOPHER ASHTON WATERS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2012
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 100 N HOWARD ST # 5684
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City | SPOKANE
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State | WA
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Zip | 99201-0508
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Country | US
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Telephone | 208-972-9988
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Fax | 877-552-0981
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Provider Business Mailing Address
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Address Line | 617 W 18TH ST
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City | THE DALLES
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State | OR
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Zip | 97058-1666
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Country | US
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Telephone | 208-972-9988
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Fax | 877-552-0981
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 202655
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3094
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60951973
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License Number State | WA
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