# MR. ADAM CHRISTIAN WACHTER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1649280132
- **Gender:** Man
- **Credential:** PT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 29521 | CA | — |
| 225100000X | Physical Therapist | OR 6654 | OR | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 11/13/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 500643799 | — | OR |
| 01 | — | ZZZ66237Z | BLUE SHIELD | CA |