Provider Demographics
NPI:1053364687
Name:FORD, CHRISTOPHER NOEL (MPT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:NOEL
Last Name:FORD
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 S 12TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2279
Mailing Address - Country:US
Mailing Address - Phone:253-564-2220
Mailing Address - Fax:253-564-2221
Practice Address - Street 1:3502 S 12TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2279
Practice Address - Country:US
Practice Address - Phone:253-564-2220
Practice Address - Fax:253-564-2221
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006703225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0147781OtherDEPT. OF L&I
WA5356FOOtherREGENCE BLUE SHIELDS
WA7106180Medicaid
WA101597600OtherU.S. DEPT. OF LABOR
WA2063203001OtherCIGNA