Provider Demographics
NPI:1629362173
Name:RAE, CHRISTEN A (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:A
Last Name:RAE
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1567 HIGHLANDS DR NE STE 110
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-6256
Mailing Address - Country:US
Mailing Address - Phone:425-996-9528
Mailing Address - Fax:425-336-3416
Practice Address - Street 1:350 SE ANDREWS ST
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3413
Practice Address - Country:US
Practice Address - Phone:248-412-3964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-05-2403103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst