Provider Demographics
NPI:1780838912
Name:EASTMAN, CHRISTINE KATE (PSYD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:KATE
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:PSYD, LCSW
Other - Prefix:DR
Other - First Name:KATE
Other - Middle Name:SWAIN
Other - Last Name:EASTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LCSW
Mailing Address - Street 1:6134 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-4092
Mailing Address - Country:US
Mailing Address - Phone:207-749-1392
Mailing Address - Fax:
Practice Address - Street 1:1909 SKYLINE WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2992
Practice Address - Country:US
Practice Address - Phone:207-749-1392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602348101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical