Provider Demographics
NPI:1568995249
Name:PORTER, CHRISTOPHER JASON (MS, LMHC, MHP, NCC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JASON
Last Name:PORTER
Suffix:
Gender:M
Credentials:MS, LMHC, MHP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 657
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-0657
Mailing Address - Country:US
Mailing Address - Phone:509-795-0518
Mailing Address - Fax:
Practice Address - Street 1:115 2ND ST UNIT 657
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-1925
Practice Address - Country:US
Practice Address - Phone:509-795-0518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60791160101YM0800X, 101Y00000X
WALH60999120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor