Provider Demographics
NPI:1194349365
Name:CHONG, CHRISTINE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:CHONG
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 ORCHARD HEIGHTS RD NW APT 2063
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-2575
Mailing Address - Country:US
Mailing Address - Phone:808-371-6322
Mailing Address - Fax:
Practice Address - Street 1:3445 BOONE RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97317-9336
Practice Address - Country:US
Practice Address - Phone:503-576-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2268225X00000X
OR2268225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist