Provider Demographics
NPI:1154778009
Name:CHUMARD, CHRISTINA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CHUMARD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 7TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2320
Mailing Address - Country:US
Mailing Address - Phone:541-967-4518
Mailing Address - Fax:541-924-3785
Practice Address - Street 1:2196 21ST AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-5445
Practice Address - Country:US
Practice Address - Phone:541-967-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR016384235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist