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General NPI Number Information
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NPI Number | 1407682313
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Entity Type | Individual
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Provider Name | CHRISTINA BEARER
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Gender |
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 122 16TH AVE E
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City | SEATTLE
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State | WA
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Zip | 98112-5212
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Country | US
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Telephone | 206-901-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 4422 CORLISS AVE N
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City | SEATTLE
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State | WA
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Zip | 98103-7657
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Country | US
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Telephone | 512-627-2343
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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