Provider Demographics
NPI:1083957690
Name:EWING, CHRISTINE MICHEL (MS COUNSELING, MFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MICHEL
Last Name:EWING
Suffix:
Gender:F
Credentials:MS COUNSELING, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20484 MAZAMA PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9809
Mailing Address - Country:US
Mailing Address - Phone:909-576-5732
Mailing Address - Fax:
Practice Address - Street 1:731 NW FRANKLIN AVE # 107
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2752
Practice Address - Country:US
Practice Address - Phone:541-306-1128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66335101YM0800X
ORT1189101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health