Provider Demographics
NPI:1205928884
Name:CRISTEL, DEANNA LYNN (LMFT)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LYNN
Last Name:CRISTEL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:LYNN
Other - Last Name:BRETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33507 9TH AVE S
Mailing Address - Street 2:BUILDING C SUITE 2
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6397
Mailing Address - Country:US
Mailing Address - Phone:253-320-0415
Mailing Address - Fax:253-661-8480
Practice Address - Street 1:33507 9TH AVE S
Practice Address - Street 2:BUILDING C SUITE 2
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6397
Practice Address - Country:US
Practice Address - Phone:253-320-0415
Practice Address - Fax:253-661-8480
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002656106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist