Healthcare Provider Details
I. General information
NPI: 1972390342
Provider Name (Legal Business Name): CHRISTINE JANENE DUCHATEAU BA, MA PSYCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
128 W ANTLER AVE
REDMOND OR
97756-1852
US
IV. Provider business mailing address
8832 40 AVENUE NW 5800 SE JERRY DR. PRINEVILLE, OREGON 97754 UNITED STATE
EDMONTON AB
T6K 1G5
CA
V. Phone/Fax
- Phone: 541-255-1192
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | C5089 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: