Provider Demographics
NPI:1598530206
Name:COLLINS, CHRISTINE HEATHER
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:HEATHER
Last Name:COLLINS
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 1:2315 VERONA ST # 7
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-3760
Mailing Address - Country:US
Mailing Address - Phone:208-627-9929
Mailing Address - Fax:
Practice Address - Street 1:1420 STATE RTE. 20, SEDRO-WOOLLEY, WA
Practice Address - Street 2:
Practice Address - City:SEDRO-WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284
Practice Address - Country:US
Practice Address - Phone:360-854-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60026183163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult