Provider Demographics
NPI:1487083614
Name:LABASS, CRYSTAL (PSYD, LMHC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:LABASS
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8226 BRACKEN PL SE
Mailing Address - Street 2:STE. 200
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9235
Mailing Address - Country:US
Mailing Address - Phone:206-557-3810
Mailing Address - Fax:425-292-3318
Practice Address - Street 1:8226 BRACKEN PL SE STE 200
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9235
Practice Address - Country:US
Practice Address - Phone:206-557-3810
Practice Address - Fax:206-547-5298
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60774651101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health