Provider Demographics
NPI:1730557364
Name:KONRAD, CHRISTINA (MACP, LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:KONRAD
Suffix:
Gender:F
Credentials:MACP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14392
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98082-2392
Mailing Address - Country:US
Mailing Address - Phone:425-420-0455
Mailing Address - Fax:
Practice Address - Street 1:16521 13TH AVE W
Practice Address - Street 2:SUITE 218
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-8528
Practice Address - Country:US
Practice Address - Phone:425-420-0455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60561744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health