Provider Demographics
NPI:1831317353
Name:LABEAU, CHRISTINE (MED, MA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:LABEAU
Suffix:
Gender:F
Credentials:MED, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 OLYMPIA AVE NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4033
Mailing Address - Country:US
Mailing Address - Phone:360-753-5511
Mailing Address - Fax:360-357-3599
Practice Address - Street 1:1005 OLYMPIA AVE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4033
Practice Address - Country:US
Practice Address - Phone:360-753-5511
Practice Address - Fax:360-357-3599
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003864101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health