Provider Demographics
NPI:1386238186
Name:VEA, CHRISTINE PATRICE KEERY
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:PATRICE KEERY
Last Name:VEA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 S 360 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2590
Mailing Address - Country:US
Mailing Address - Phone:503-209-2635
Mailing Address - Fax:
Practice Address - Street 1:1705 CENTENNIAL BLVD STE 2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-3320
Practice Address - Country:US
Practice Address - Phone:503-209-2635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL160311041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical