Provider Demographics
NPI:1740039049
Name:SANDE, CHRISTOPHER REUEL
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:REUEL
Last Name:SANDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 147TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-5606
Mailing Address - Country:US
Mailing Address - Phone:425-275-3879
Mailing Address - Fax:
Practice Address - Street 1:319 147TH AVE SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-5606
Practice Address - Country:US
Practice Address - Phone:425-275-3879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health