Provider Demographics
NPI:1912586223
Name:CHRISTIE - FOSTER, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:CHRISTIE - FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 E HOLLAND AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-5016
Mailing Address - Country:US
Mailing Address - Phone:509-309-4247
Mailing Address - Fax:
Practice Address - Street 1:775 E HOLLAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-5016
Practice Address - Country:US
Practice Address - Phone:509-309-4247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
WAMG61433327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician