Provider Demographics
NPI:1295046563
Name:COLE, CHRISTINE CAROL (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CAROL
Last Name:COLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 S 380TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-9433
Mailing Address - Country:US
Mailing Address - Phone:253-709-2760
Mailing Address - Fax:
Practice Address - Street 1:30012 MILITARY RD S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4230
Practice Address - Country:US
Practice Address - Phone:253-709-2760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60144444101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH60144444OtherWASHINGTON STATE DEPARTMENT OF HEALTH