Provider Demographics
NPI:1407556913
Name:SMITH, CHRISTY BRADY (PHD, MSW)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:BRADY
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 245TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-2566
Mailing Address - Country:US
Mailing Address - Phone:206-355-3426
Mailing Address - Fax:
Practice Address - Street 1:5615 245TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-2566
Practice Address - Country:US
Practice Address - Phone:206-355-3426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC612935581041C0700X
WAMC61284527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical