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General NPI Number Information
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NPI Number | 1568454999
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Entity Type | Individual
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Provider Name | CHRISTIIAN T LEWIS ARNP
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 1550 S PIONEER WAY
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City | MOSES LAKE
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State | WA
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Zip | 98837-4613
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Country | US
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Telephone | 509-793-9785
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Fax | 509-764-3252
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Provider Business Mailing Address
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Address Line | 660 S COOLIDGE ST
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City | MOSES LAKE
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State | WA
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Zip | 98837-1872
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Country | US
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Telephone | 509-793-9715
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Fax | 509-764-3255
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP30005943
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License Number State | WA
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