MEDICARE: CHRISTIIAN T LEWIS ARNP

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
1	363L00000X	Nurse Practitioner	AP30005943	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568454999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIIAN T LEWIS ARNP

Provider Business Mailing Address
First Line	:	660 S COOLIDGE ST
Second Line	:
City	:	MOSES LAKE
State	:	WA
Zip	:	98837-1872
Country	:	US
Telephone Number	:	509-793-9715
Fax Number	:	509-764-3255

Provider Business Practice Location Address
First Line	:	1550 S PIONEER WAY
Second Line	:
City	:	MOSES LAKE
State	:	WA
Zip	:	98837-4613
Country	:	US
Telephone Number	:	509-793-9785
Fax Number	:	509-764-3252

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	12/14/2022

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