Provider Demographics
NPI:1992296040
Name:PELZ, CHRISTIE ANN (LASW, MHP, CMHS)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:ANN
Last Name:PELZ
Suffix:
Gender:F
Credentials:LASW, MHP, CMHS
Other - Prefix:MS
Other - First Name:CHRISTIE
Other - Middle Name:ANN
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LASW, MHP, CMHS
Mailing Address - Street 1:1321 W. BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201
Mailing Address - Country:US
Mailing Address - Phone:509-473-4810
Mailing Address - Fax:509-473-4840
Practice Address - Street 1:1321 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201
Practice Address - Country:US
Practice Address - Phone:509-473-4829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker