Provider Demographics
NPI:1558094466
Name:EVERS, CHRISTINE IRENE (LICSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:IRENE
Last Name:EVERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CUSICK
Mailing Address - State:WA
Mailing Address - Zip Code:99119-6002
Mailing Address - Country:US
Mailing Address - Phone:509-863-3778
Mailing Address - Fax:
Practice Address - Street 1:713 RIVER RD
Practice Address - Street 2:
Practice Address - City:CUSICK
Practice Address - State:WA
Practice Address - Zip Code:99119-6002
Practice Address - Country:US
Practice Address - Phone:509-863-3778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60819537101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor