Provider Demographics
NPI:1619386356
Name:NELTHROPP, CHRYSTAL (MA)
Entity Type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:
Last Name:NELTHROPP
Suffix:
Gender:F
Credentials:MA
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 797
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:OR
Mailing Address - Zip Code:97138-0797
Mailing Address - Country:US
Mailing Address - Phone:206-390-6249
Mailing Address - Fax:
Practice Address - Street 1:35850 7TH STREET
Practice Address - Street 2:
Practice Address - City:NEHALEM
Practice Address - State:OR
Practice Address - Zip Code:97131-9518
Practice Address - Country:US
Practice Address - Phone:206-390-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61416228101YM0800X
ORC4615101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health