Provider Demographics
NPI:1629253729
Name:CHRISTIAN, CHRISTINE ELLEN (MA LMHC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ELLEN
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:MS
Other - First Name:CHRISTY
Other - Middle Name:ELLEN
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LMHC
Mailing Address - Street 1:920 ALDER AVE
Mailing Address - Street 2:SUITE 203A
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390
Mailing Address - Country:US
Mailing Address - Phone:253-370-7970
Mailing Address - Fax:
Practice Address - Street 1:920 ALDER AVE
Practice Address - Street 2:SUITE 203A
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390
Practice Address - Country:US
Practice Address - Phone:253-370-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009528101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health