Provider Demographics
NPI:1538375027
Name:RYAN, CHRISTINA MARY (MSLMHC, LMFT, LCSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARY
Last Name:RYAN
Suffix:
Gender:F
Credentials:MSLMHC, LMFT, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8127 149TH PL NE UNIT D321
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6597
Mailing Address - Country:US
Mailing Address - Phone:646-541-5327
Mailing Address - Fax:
Practice Address - Street 1:8127 149TH PL NE UNIT D321
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6597
Practice Address - Country:US
Practice Address - Phone:646-541-5327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMHC.LH.60116989101YM0800X
IN34002420A1041C0700X
IN35000130A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMHC.LH.60116989OtherLMHC
IN34002420AOtherLCSW
IN35000130AOtherLMFT