Provider Demographics
NPI:1902044431
Name:MITCHELL, CHRISTOPHER (MSSW, MPA, LSWAIC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MSSW, MPA, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19707 44TH AVE W
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6757
Mailing Address - Country:US
Mailing Address - Phone:425-977-2560
Mailing Address - Fax:
Practice Address - Street 1:19707 44TH AVE W
Practice Address - Street 2:SUITE 101
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6757
Practice Address - Country:US
Practice Address - Phone:347-867-5724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
WASC60608753104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No172V00000XOther Service ProvidersCommunity Health Worker