Provider Demographics
NPI:1265027015
Name:COLYAR, CRISTY A
Entity Type:Individual
Prefix:
First Name:CRISTY
Middle Name:A
Last Name:COLYAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 CENTRAL DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3475
Mailing Address - Country:US
Mailing Address - Phone:907-521-0624
Mailing Address - Fax:
Practice Address - Street 1:120 E FIR ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2964
Practice Address - Country:US
Practice Address - Phone:360-419-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator