Provider Demographics
NPI:1700153699
Name:OVIATT, CHRISTINE GRACE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:GRACE
Last Name:OVIATT
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 1:2323 NW 188TH AVE
Mailing Address - Street 2:APT. 824
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7039
Mailing Address - Country:US
Mailing Address - Phone:503-640-9892
Mailing Address - Fax:503-648-9732
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4191
Practice Address - Country:US
Practice Address - Phone:503-640-9892
Practice Address - Fax:503-648-9732
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health