Healthcare Provider Details

I. General information

NPI: 1588083208
Provider Name (Legal Business Name): KRISTINE WILLIAMS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 6TH ST STE 108
ANACORTES WA
98221-1798
US

IV. Provider business mailing address

1015 6TH ST STE 108
ANACORTES WA
98221-1798
US

V. Phone/Fax

Practice location:
  • Phone: 360-421-3969
  • Fax:
Mailing address:
  • Phone: 360-421-3969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60724035
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: