MR. CHRISTOPHER RAY SUNDQUIST (NPI# 1366510752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366510752 |
| Entity Type | Individual |
| Full Name | MR. CHRISTOPHER RAY SUNDQUIST |
| Credential | PAC |
| Practice Address |
6101 W Hwy 54 Suite A Athol ID 83801 |
| Mailing Address |
Po Box 775 Athol ID 83801 |
| Practice Telephone | 2086830800 |
| Practice Fax Number | 2086830900 |
| Mailing Telephone | 2086830800 |
| Mailing Fax Number | 2086830900 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA-303 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS PIN | PAD92 | 01 |
| ID | REGENCE PIN | 000010158675 | 01 |
| Street Address |
6101 W HWY 54 SUITE A |
| City | ATHOL |
| State | ID |
| Zip Code | 83801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053496869 | Connie Jean Stone | Massage Therapist | 6115 E Hwy 54, Athol, ID 83801 | 2006-10-27 |
| 1659568871 | Carrie Valentine Blake | Midwife | 3155 Gwenn Ct, Athol, ID 83801-4909 | 2007-10-02 |
| 1952673204 | Donald K Merkeley | Pathology | 16301 E Bunco Rd, Athol, ID 83801-5048 | 2012-02-02 |
| 1366982316 | Davina Gelardi | Massage Therapist | 6101 E Highway 54, Athol, ID 83801-6085 | 2017-02-24 |
| 1578956637 | Country Clinical Massage | Massage Therapist | 6101 E Highway 54 Ste A, Athol, ID 83801-6085 | 2015-03-13 |
| 1629513940 | Kelly Sorensen | Lactation Consultant, Non-RN | 23582 Rapalla Ct, Athol, ID 83801-7002 | 2016-12-21 |
| 1720390347 | Charla-jo Olorenshaw Spradlin | Physical Therapist | 26453 N Old Highway 95, Athol, ID 83801-7076 | 2010-07-12 |
| 1174783724 | Tamara Marie Barnhart | Chiropractor | 6101 E Highway 54, Unit A, Athol, ID 83801-8255 | 2008-06-16 |
| 1932392933 | Timberlake Family Medicine | Clinic/Center | 6101 E Highway 54 Ste A, Athol, ID 83801-8255 | 2007-08-22 |
| 1861632028 | Natural Health Chiropractic LLC | Clinic/Center | 6101 E Highway 54, Unit A, Athol, ID 83801-8255 | 2009-03-02 |
| Find all providers in zip 83801 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689217911 | David Jeffrey Hanson | Physician Assistant | 740 Mckinley Ave Ste 100, Kellogg, ID 83837-2693 | 2019-10-18 |
| 1871060681 | Travis Henman | Physician Assistant | 1404 Pomerelle Ave Ste 150, Burley, ID 83318-2012 | 2018-10-30 |
| 1952889685 | Cody Mattingly | Physician Assistant | 14601 S Pleasant Valley Rd, Kuna, ID 83634-2728 | 2018-08-03 |
| 1992174072 | Alexa Rhea | Physician Assistant | 2841 Juniper Dr Ste 2, Lewiston, ID 83501-4719 | 2015-09-18 |
| 1043689441 | Derek R Wynn | Physician Assistant | 607 W Main Street, Grangeville, ID 83530 | 2015-09-16 |
| 1407223274 | Michael Kenneth Wucinich | Physician Assistant | 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301-5823 | 2015-08-28 |
| 1811364177 | Ashley Laren Popadics | Physician Assistant | 1510 12th Ave Rd Ste 200, Nampa, ID 83686-6008 | 2015-08-21 |
| 1073915963 | Jessica Bishop | Physician Assistant | 1499 W Hays St, Boise, ID 83702-5029 | 2014-09-23 |
| 1447652813 | Jessea Camille Whitlow | Physician Assistant | 2392 Addison Ave E, Twin Falls, ID 83301-6745 | 2014-09-17 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.