Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY00002437 | WA |
Y | 103TC0700X | Clinical Psychologist | PY00002437 | WA |
NPI | 1003860776 |
---|---|
Provider Name | Dr. Christopher Nelson |
First Address | Vancouver, WA 98662-3721 |
Second Address | Mount Vernon, WA 98274-4639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 13/01/2017 |