Provider Demographics
NPI:1891860151
Name:DAVERIO, CHRISTINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:DAVERIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 BOTHELL EVERETT HWY.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012
Mailing Address - Country:US
Mailing Address - Phone:425-357-9100
Mailing Address - Fax:425-357-9100
Practice Address - Street 1:16000 BOTHELL EVERETT HWY
Practice Address - Street 2:STE 166
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1514
Practice Address - Country:US
Practice Address - Phone:425-357-9100
Practice Address - Fax:425-357-9100
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000058631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical