Healthcare Provider Details

I. General information

NPI: 1346651098
Provider Name (Legal Business Name): CHRISTINA MARIE WELLMAN L.M.H.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 4TH AVE E STE 200
OLYMPIA WA
98506-6512
US

IV. Provider business mailing address

2101 4TH AVE E STE 200
OLYMPIA WA
98506-6512
US

V. Phone/Fax

Practice location:
  • Phone: 360-358-2085
  • Fax:
Mailing address:
  • Phone: 360-358-2085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60502687
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: