CRISTINA DUVALL (NPI# 1750612123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750612123 |
| Entity Type | Individual |
| Full Name | CRISTINA DUVALL |
| Credential | SUDP |
| Practice Address |
621 Grade St Kelso WA 98626-2606 |
| Mailing Address |
1057 12th Ave Longview WA 98632-2509 |
| Practice Telephone | 3604259210 |
| Practice Fax Number | 3605016131 |
| Mailing Telephone | 3604259210 |
| Mailing Fax Number | 3602328400 |
| Enumeration Date | 2010-01-24 |
| Last Update Date | 2020-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CP61042964 | WA | Behavioral Health & Social Service Providers |
| N | 183500000X | Pharmacist | PH00069477 | WA | Pharmacy Service Providers |
| Street Address |
621 GRADE ST |
| City | KELSO |
| State | WA |
| Zip Code | 98626-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063933406 | Julia A Spalding | Counselor | 621 Grade St, Kelso, WA 98626-2606 | 2017-07-06 |
| 1295113744 | Amber Delagrange | Counselor | 621 Grade St, Kelso, WA 98626-2606 | 2015-05-15 |
| 1083092548 | Deborah Smith | Counselor | 621 Grade St, Kelso, WA 98626-2606 | 2015-05-15 |
| 1215323977 | Michelle Buckholz | Counselor | 621 Grade St, Kelso, WA 98626-2606 | 2015-04-09 |
| 1609266717 | Rama Mitchell Jr. | Counselor | 621 Grade St, Kelso, WA 98626-2606 | 2015-01-27 |
| 1104243534 | Cowlitz Family Health Center | Clinic/Center | 621 Grade St, Kelso, WA 98626-2606 | 2014-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730581877 | Wrothell Funchess | Counselor | 1645 Bowmont Ave, Kelso, WA 98626 | 2014-09-19 |
| 1427457688 | Julie Dalen | Counselor | 309 Oak Street, Kelso, WA 98626 | 2014-08-13 |
| 1033468822 | Rene Kerry Bohannon-oxford | Counselor | 2707 Pacific Ave North, Kelso, WA 98626 | 2012-09-07 |
| 1447535737 | Nichole Kathleen Allee | Massage Therapist | 109 Nw 1st St., Kelso, WA 98626 | 2011-10-18 |
| 1689991655 | Zachariah Kramer | Radiology | 700 Lincoln Street Suite 100, Longview Radiologists, Kelso, WA 98626 | 2010-04-29 |
| 1508007071 | Robert Lee Blair | Registered Nurse | 119 Blackburn Lane, Kalama, WA 98626 | 2009-03-13 |
| 1942318829 | Imholte & Anderson Pllc | Dentist | 409 West Main Street, Kelso, WA 98626 | 2006-08-29 |
| 1922088723 | James Bevan Hollingsworth | Pharmacist | 204 S Pacific Ave, Kelso, WA 98626 | 2006-01-18 |
| 1972021087 | Adreia Jenice Jessop | Registered Nurse | 300 Oak St, Kelso, WA 98626 | 2017-09-08 |
| 1023567310 | Charlene Han | Pharmacist | 205 Three Rivers Dr, Kelso, WA 98626 | 2016-09-27 |
| Find all providers in zip 98626 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447619234 | Jessica Ferguson | Counselor | 210 Pacific Ave N, Kelso, WA 98626-3414 | 2016-02-22 |
| 1679122386 | Anna Saiz | Counselor | 305 Pacific Ave S Ste C, Kelso, WA 98626-1638 | 2019-09-05 |
| 1104488857 | Brittany Lynn Birtchet | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2019-07-02 |
| 1083278196 | Tessia Renee Taylor | Counselor | 305 Pacific Ave S Ste C, Kelso, WA 98626-1638 | 2019-04-24 |
| 1881151850 | Ryan Lorenzo | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2019-02-26 |
| 1922564962 | Teresa Lee Brunelle | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2019-02-14 |
| 1174087613 | Margaret Diane Fraze | Counselor | 305 Pacific Ave S Ste C, Kelso, WA 98626-1638 | 2019-01-29 |
| 1760955272 | Bryanna Marie Jellum | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2019-01-07 |
| 1467923151 | Kathleen Frances Loney | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2018-12-06 |
| 1467922906 | Breanna Slape-lorenzo | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2018-11-27 |
| Find all providers in KELSO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.