Provider Demographics
NPI:1700335858
Name:KAZLAS, CHRISTINA GAIL
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:GAIL
Last Name:KAZLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-2619
Mailing Address - Country:US
Mailing Address - Phone:971-701-8874
Mailing Address - Fax:
Practice Address - Street 1:111 N GARFIELD ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-2619
Practice Address - Country:US
Practice Address - Phone:971-701-8874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist