Provider Demographics
NPI:1669131520
Name:GUTHRIE, CHRISTY DAWN
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:DAWN
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S WILBUR AVE
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3532
Mailing Address - Country:US
Mailing Address - Phone:509-529-6036
Mailing Address - Fax:
Practice Address - Street 1:410 S WILBUR AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3532
Practice Address - Country:US
Practice Address - Phone:509-529-6036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)