Provider Demographics
NPI:1134904915
Name:ADAMS, CHRISTINE KIMBERLEE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KIMBERLEE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:KIMBERLEE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 OLD PINEVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1944
Mailing Address - Country:US
Mailing Address - Phone:208-565-0164
Mailing Address - Fax:
Practice Address - Street 1:875 OAK ST SE STE 5060
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3987
Practice Address - Country:US
Practice Address - Phone:503-399-1386
Practice Address - Fax:503-399-1182
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical