Provider Demographics
NPI:1699963017
Name:TABBADA, CHRISTABEL G (LAC)
Entity type:Individual
Prefix:
First Name:CHRISTABEL
Middle Name:G
Last Name:TABBADA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 NE HIGHWAY 20 STE 610-447
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6402
Mailing Address - Country:US
Mailing Address - Phone:949-355-3868
Mailing Address - Fax:
Practice Address - Street 1:568 NE SAVANNAH DR STE 5
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4866
Practice Address - Country:US
Practice Address - Phone:541-668-1881
Practice Address - Fax:888-658-6924
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8611171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORAC192976OtherOREGON MEDICAL BOARD
CAAC8611OtherCA ACUPUNCTURE LICENSE