Provider Demographics
NPI:1104935097
Name:KAPLAN, CHRISTOPHER W (PAC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:W
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1611 N RAMBO RD
Mailing Address - Street 2:
Mailing Address - City:MEDICAL LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99022
Mailing Address - Country:US
Mailing Address - Phone:509-244-5121
Mailing Address - Fax:
Practice Address - Street 1:701 HOSPITAL LOOP RD FAFB
Practice Address - Street 2:FAMILY HEALTH CENTER 92ND MEDICAL GROUP
Practice Address - City:FAIRCHILD AFB
Practice Address - State:WA
Practice Address - Zip Code:99011-5300
Practice Address - Country:US
Practice Address - Phone:509-247-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10001097363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical