Basic Information
| Provider Information | |||||||||
| NPI: | 1831310747 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECHTOLD MORSE | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 790 REMINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604404909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302962223 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25012 104TH AVE SE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | KENT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980302821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538563477 | ||||||||
| FaxNumber: | 2538563478 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT9329 | CO | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT 60210062 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0290938 | 01 | WA | DEPT. OF LABOR AND INDUSTRIES | OTHER | 1831310747 | 05 | WA | MEDICAID | NORTHERN IL UNIV | 01 | IL | MASTER PHYSICAL THERAPY | OTHER | P01276066 | 01 | WA | MEDICARE RAILROAD | OTHER |