Provider Demographics
NPI:1740063361
Name:CLAY, CHRISTOPHER (CHW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CLAY
Suffix:
Gender:M
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 N HOLY NAMES CT FL 3
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-5803
Mailing Address - Country:US
Mailing Address - Phone:509-242-2308
Mailing Address - Fax:509-455-4988
Practice Address - Street 1:1960 N HOLY NAMES CT FL 3
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-5803
Practice Address - Country:US
Practice Address - Phone:509-242-2308
Practice Address - Fax:509-455-4988
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X, 390200000X, 101Y00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program