Provider Demographics
NPI:1972755734
Name:TAND, KRISTIN K (LMHC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:K
Last Name:TAND
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:K
Other - Last Name:POAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, LPC
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-764-3335
Mailing Address - Fax:206-764-0489
Practice Address - Street 1:1601 E 4TH PLAIN BLVD BLDG 17
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3753
Practice Address - Country:US
Practice Address - Phone:360-397-8484
Practice Address - Fax:360-397-8494
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60275222101YM0800X
ORC2789101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health