Provider Demographics
NPI:1104532027
Name:SLATTER, CHRYSTAL (CERTIFIED PEER COUNS)
Entity type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:
Last Name:SLATTER
Suffix:
Gender:F
Credentials:CERTIFIED PEER COUNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14121 S HIGHWAY 21
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:WA
Mailing Address - Zip Code:99140-9529
Mailing Address - Country:US
Mailing Address - Phone:509-680-1404
Mailing Address - Fax:
Practice Address - Street 1:909 W MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2031
Practice Address - Country:US
Practice Address - Phone:206-552-0882
Practice Address - Fax:949-955-5758
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist