Provider Demographics
NPI:1992330856
Name:SHELLER, CHRISTOPHER M
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:SHELLER
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 1:1804 E PACIFIC AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3227
Mailing Address - Country:US
Mailing Address - Phone:509-385-8673
Mailing Address - Fax:
Practice Address - Street 1:2222 N MONROE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4545
Practice Address - Country:US
Practice Address - Phone:509-413-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist