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General NPI Number Information
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NPI Number | 1487032686
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Entity Type | Individual
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Provider Name | CHRISTINE LYNNE RECORD HCA, BA, SUDPT, NAR
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Gender | Female
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 1601 E 4TH PLAIN BLVD BLDG 17
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City | VANCOUVER
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State | WA
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Zip | 98661-3717
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Country | US
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Telephone | 360-397-8246
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1772
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City | VANCOUVER
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State | WA
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Zip | 98668-1772
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Country | US
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Telephone | 360-852-0014
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CO61391660
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | HM60390306
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License Number State | WA
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