Provider Demographics
NPI:1861792434
Name:ST CHRISTOPHER, SUMMER MICAIAH (LCMT)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:MICAIAH
Last Name:ST CHRISTOPHER
Suffix:
Gender:F
Credentials:LCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7803 W DESCHUTES AVE
Mailing Address - Street 2:#D-114
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1686
Mailing Address - Country:US
Mailing Address - Phone:301-802-4010
Mailing Address - Fax:
Practice Address - Street 1:1045 JADWIN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3405
Practice Address - Country:US
Practice Address - Phone:301-802-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60183784174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist