Provider Demographics
NPI:1982338075
Name:CHRISTENSEN, HALEY MARIE
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MARIE
Last Name:CHRISTENSEN
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 1:1731 W OHIO MATCH RD
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-6502
Mailing Address - Country:US
Mailing Address - Phone:208-918-4654
Mailing Address - Fax:
Practice Address - Street 1:101 W CASCADE WAY STE 103
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6000
Practice Address - Country:US
Practice Address - Phone:509-413-2242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist