Provider Demographics
NPI:1275016834
Name:LOUK, CRISTINA (PHD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:LOUK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13791 195TH DR SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-7720
Mailing Address - Country:US
Mailing Address - Phone:425-276-0612
Mailing Address - Fax:
Practice Address - Street 1:13791 195TH DR SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-7720
Practice Address - Country:US
Practice Address - Phone:425-276-0612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61394091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty