Individual
MS. KRISTINE ROOP CHAMPAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2208 NW MARKET ST, SUITE 412, SEATTLE, WA 98107-4030
(206) 501-4059
Mailing address
2208 NW MARKET ST, SUITE 412, SEATTLE, WA 98107-4030
(206) 501-4059
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
100774
MA
1041C0700X
Clinical Social Worker
Primary
LW60012216
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000246
CIGNA
WA
05
—
1852388
—
MA
01
—
1892967
MBHP
MA
01
—
5776242
AETNA
WA
01
—
6A849
PREMERA
WA
01
—
761512
TUFTS HEALTH PLANS
MA
01
—
P02025
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/13/2006
Last updated
06/29/2012
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