Basic Information
| Provider Information | |||||||||
| NPI: | 1275765810 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAN | ||||||||
| FirstName: | CHRISTOPHER BRYAN | ||||||||
| MiddleName: | DANAQUE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 SUMMITVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989022715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486616 | ||||||||
| FaxNumber: | 5092252708 | ||||||||
| Practice Location | |||||||||
| Address1: | 3909 CREEKSIDE LOOP STE 120 | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989024880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486616 | ||||||||
| FaxNumber: | 5092252708 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2009 | ||||||||
| LastUpdateDate: | 06/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD60614220 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.