Healthcare Provider Details

I. General information

NPI: 1619570322
Provider Name (Legal Business Name): CHRISTINE LYNN MCCAMBRIDGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 NE HIGHWAY 101 STE 200
LINCOLN CITY OR
97367-4464
US

IV. Provider business mailing address

2600 NE HIGHWAY 101 STE 200
LINCOLN CITY OR
97367-4464
US

V. Phone/Fax

Practice location:
  • Phone: 541-921-3584
  • Fax: 541-614-1291
Mailing address:
  • Phone: 541-921-3584
  • Fax: 541-614-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE MCCAMBRIDGE
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 419-213-5845