Provider Demographics
NPI:1124326368
Name:KEYS, CHRISTINE LEAH (MA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LEAH
Last Name:KEYS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31919 1ST AVE S
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5236
Mailing Address - Country:US
Mailing Address - Phone:253-839-4172
Mailing Address - Fax:484-924-3832
Practice Address - Street 1:31919 1ST AVE S
Practice Address - Street 2:SUITE 203
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5236
Practice Address - Country:US
Practice Address - Phone:253-839-4172
Practice Address - Fax:484-924-3832
Is Sole Proprietor?:No
Enumeration Date:2011-03-12
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60279408101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health