Provider Demographics
NPI:1043419369
Name:PHILLIPS, CHRISTINE ELIZABETH (MS-CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MS-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18606 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:WA
Mailing Address - Zip Code:99016-8654
Mailing Address - Country:US
Mailing Address - Phone:509-922-4931
Mailing Address - Fax:
Practice Address - Street 1:18606 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:WA
Practice Address - Zip Code:99016-8654
Practice Address - Country:US
Practice Address - Phone:509-922-4931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA400724A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist