Provider Demographics
NPI:1699336636
Name:PROCHASKA, CHRISTOPHER MICAH (ND)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICAH
Last Name:PROCHASKA
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 YAKIMA ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2815
Mailing Address - Country:US
Mailing Address - Phone:831-905-1924
Mailing Address - Fax:
Practice Address - Street 1:522 YAKIMA ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2815
Practice Address - Country:US
Practice Address - Phone:831-905-1924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60984878175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath