Provider Information for 1407122641
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CHRISTOPHER ASHTON WATERS Ph.D.
Sex: Male
NPI: 1407122641
Last Updated: 2024-09-09
Certification Date: 2024-09-09
Certification Date: 2024-09-09
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1407122641 | ||||||||||||||||
| Enumeration Date | 2012-03-31 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 617 W 18TH ST THE DALLES, OR 97058-1666 United States Phone: 208-972-9988 | Fax:877-552-0981 | ||||||||||||||||
| Primary Practice Address | 100 N HOWARD ST # 5684 SPOKANE, WA 99201-0508 United States Phone: 208-972-9988 | Fax:877-552-0981 | ||||||||||||||||
| Secondary Practice Address(es) | 3308 N COLE RD | ||||||||||||||||
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