Provider Demographics
NPI:1073949244
Name:KOEPP, CHRISTINA (LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:KOEPP
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 SW CLOVERDALE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3734
Mailing Address - Country:US
Mailing Address - Phone:425-440-1024
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:3403 SW CLOVERDALE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3734
Practice Address - Country:US
Practice Address - Phone:425-440-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LH60878120.101Y00000X
101Y00000X
WAMC60419745101YM0800X
WALH60878120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor