Provider Demographics
NPI:1386206019
Name:RASMUSSON, CHRIS J
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:J
Last Name:RASMUSSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2155
Mailing Address - Country:US
Mailing Address - Phone:218-625-1400
Mailing Address - Fax:
Practice Address - Street 1:118 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2155
Practice Address - Country:US
Practice Address - Phone:218-625-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator