Provider Demographics
NPI:1457954901
Name:CHEN, CRYSTAL (ATR-BC, LCAT, LMHC)
Entity Type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:ATR-BC, LCAT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12510 109TH CT NE APT E202
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-0810
Mailing Address - Country:US
Mailing Address - Phone:425-736-9704
Mailing Address - Fax:
Practice Address - Street 1:12510 109TH CT NE APT E202
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-0810
Practice Address - Country:US
Practice Address - Phone:425-736-9704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002456221700000X
WALH61194196101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist