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NPI Code Detail

MEDICARE: CHRISTOPHER WADE NIXON-KLEWENO PT

MEDICARE: CHRISTOPHER WADE NIXON-KLEWENO PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00003743WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2189561OTHERWAL&I

General Provider Information

NPI Number : 1326070616
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER WADE NIXON-KLEWENO PT
Provider Business Mailing Address
First Line : 2710 E 57TH AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99223-6678
Country : US
Telephone Number : 509-252-2354
Fax Number : 509-252-2357
Provider Business Practice Location Address
First Line : 2710 E 57TH AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99223-6678
Country : US
Telephone Number : 509-252-2354
Fax Number : 509-252-2357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 12/15/2021

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