Provider Demographics
NPI:1700401320
Name:MANUEL, CHRISTOPHER MICHAEL (DNP)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:MANUEL
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 KRUSE WAY STE 125
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3533
Mailing Address - Country:US
Mailing Address - Phone:541-206-0592
Mailing Address - Fax:
Practice Address - Street 1:4550 KRUSE WAY STE 125
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3533
Practice Address - Country:US
Practice Address - Phone:541-206-0592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2025-01-30
Deactivation Date:2025-01-22
Deactivation Code:
Reactivation Date:2025-01-30
Provider Licenses
StateLicense IDTaxonomies
OR10038521363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily