| Doctor Name: | MR. CHRISTOPHER PAUL JACQUES |
| NPI Number: | 1598030256 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 872 W Main St Apt C27 Molalla, OR - 970388865 |
| Business Phone Number: | 5039847899 |
| Business Fax Number: | |
| Mailing Address: | 872 W Main St Apt C27, MOLALLA |
| State: | OR |
| Postal Code: | 970388865 |
| Phone Number: | 5039847899 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2012 |
| NPI Last Update Date: | 03/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156F00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |