Basic Information
| Provider Information | |||||||||
| NPI: | 1831368117 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OVERFIELD | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | LMP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13807 250TH AVE SE | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252602028 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1830 BICKFORD AVE | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | SNOHOMISH | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605687774 | ||||||||
| FaxNumber: | 3605687779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2008 | ||||||||
| LastUpdateDate: | 01/25/2012 | ||||||||
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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 | 225700000X | MA00024604 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0021OV | 01 | WA | REGENCE | OTHER | 0022OV | 01 | WA | REGENCE | OTHER | 0269578 | 01 | WA | DEPT L&I | OTHER | 0229622 | 01 | WA | DEPT L&I | OTHER | 0025OV | 01 | WA | REGENCE | OTHER | 0026OV | 01 | WA | REGENCE | OTHER | 0023OV | 01 | WA | REGENCE | OTHER | 0024OV | 01 | WA | REGENCE | OTHER | 0027OV | 01 | WA | REGENCE | OTHER |