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General NPI Number Information
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NPI Number | 1609665991
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Entity Type | Individual
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Provider Name | CHRISTIAN FRANK CONNELL LMHC
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Gender | Male
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 2614 FORT VANCOUVER WAY STE D
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City | VANCOUVER
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State | WA
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Zip | 98661-3971
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Country | US
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Telephone | 360-696-4895
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Fax | 360-696-4044
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Provider Business Mailing Address
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Address Line | 12225 SE WIESE RD
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City | DAMASCUS
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State | OR
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Zip | 97089-8354
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Country | US
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Telephone | 971-404-5123
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61252438
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License Number State | WA
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