Individual
MR. CHRISTIAN LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-3840
Mailing address
3012 NW 199TH ST, RIDGEFIELD, WA 98642-9560
(360) 265-2387
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA170287
OR
Other
Enumeration date
04/11/2013
Last updated
10/22/2015
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