Provider Demographics
NPI:1285431734
Name:LICHTANSKI, KRISTOPHER (PHD)
Entity type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:
Last Name:LICHTANSKI
Suffix:
Gender:
Credentials:PHD
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 305
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-0305
Mailing Address - Country:US
Mailing Address - Phone:206-451-7020
Mailing Address - Fax:
Practice Address - Street 1:16007 264TH ST E
Practice Address - Street 2:
Practice Address - City:ORTING
Practice Address - State:WA
Practice Address - Zip Code:98360-9750
Practice Address - Country:US
Practice Address - Phone:206-451-7020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61404164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health