Provider Demographics
NPI:1750850509
Name:RAY, KRISTINA JANE (LMHC, CDP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:JANE
Last Name:RAY
Suffix:
Gender:F
Credentials:LMHC, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 N SORENSON CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-7083
Mailing Address - Country:US
Mailing Address - Phone:509-863-9710
Mailing Address - Fax:509-477-6683
Practice Address - Street 1:1100 W MALLON AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99260-2043
Practice Address - Country:US
Practice Address - Phone:509-477-6674
Practice Address - Fax:509-477-6683
Is Sole Proprietor?:No
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60274583101YA0400X
WALH00011365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)