Provider Demographics
NPI:1124329636
Name:BEADLE, CHRISTOPHER DOUGLAS (DPT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:DOUGLAS
Last Name:BEADLE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 N DRUMHELLER ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-7513
Mailing Address - Country:US
Mailing Address - Phone:509-981-0934
Mailing Address - Fax:
Practice Address - Street 1:2903 E 25TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4992
Practice Address - Country:US
Practice Address - Phone:509-536-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60093447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist