Provider Demographics
NPI:1982235958
Name:WELLER, CHRISTI ANN
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:ANN
Last Name:WELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTI
Other - Middle Name:ANN
Other - Last Name:JONES, STRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45770 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CONCRETE
Mailing Address - State:WA
Mailing Address - Zip Code:98237
Mailing Address - Country:US
Mailing Address - Phone:360-416-1733
Mailing Address - Fax:360-853-7555
Practice Address - Street 1:45770 MAIN STREET
Practice Address - Street 2:45770 MAIN STREET
Practice Address - City:CONCRETE
Practice Address - State:WA
Practice Address - Zip Code:98237
Practice Address - Country:US
Practice Address - Phone:360-416-1733
Practice Address - Fax:360-853-7555
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 171M00000X
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist