Basic Information
Provider Information
NPI: 1558425900
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUNT
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 421 SW OAK ST
Address2: SUITE 520
City: PORTLAND
State: OR
PostalCode: 972041817
CountryCode: US
TelephoneNumber: 5039885464
FaxNumber:  
Practice Location
Address1: 421 SW OAK ST
Address2: SUITE 520
City: PORTLAND
State: OR
PostalCode: 972041817
CountryCode: US
TelephoneNumber: 5039885464
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/20/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YS0200X  Y Behavioral Health & Social Service ProvidersCounselorSchool

No ID Information.


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