Provider Demographics
NPI:1235332669
Name:HUGHES, CHRISTINE MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 SE 192ND AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7415
Mailing Address - Country:US
Mailing Address - Phone:360-210-5440
Mailing Address - Fax:
Practice Address - Street 1:1554 GARDEN ST
Practice Address - Street 2:STE 103
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3278
Practice Address - Country:US
Practice Address - Phone:503-723-0347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR140226Medicare PIN