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General NPI Number Information
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NPI Number | 1558905315
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Entity Type | Individual
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Provider Name | CHRISTINE GRAY
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Gender | Female
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 22717 SE 29TH ST STE D-101
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City | SAMMAMISH
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State | WA
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Zip | 98075-9532
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Country | US
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Telephone | 425-269-3277
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Fax |
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Provider Business Mailing Address
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Address Line | 995 7TH AVE NW
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City | ISSAQUAH
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State | WA
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Zip | 98027-2776
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Country | US
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Telephone | 206-867-4747
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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 | 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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