Healthcare Provider Details

I. General information

NPI: 1003322314
Provider Name (Legal Business Name): CHRISTINA IRENE CHANDLER M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 12/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SW HOLDEN ST
SEATTLE WA
98126-3505
US

IV. Provider business mailing address

3295 SW AVALON WAY APT 411
SEATTLE WA
98126-2789
US

V. Phone/Fax

Practice location:
  • Phone: 206-390-8560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number506270H
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number60794965
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: