Christopher Charles Staeheli, M.D.J.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

80222 Issued in MT

Practice address

4422 6TH Ave SE
Lacey, WA 98503-1020

Phone

(360) 236-7199

Fax

(360) 412-4982

NPI assigned

Jul 22, 2005

Last updated

Mar 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavioral Health Resources

  • Community/Behavioral Health Agency
  • Elma, WA
  • NPI 1306918750
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1629078373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 N 25TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984067105",
            "telephone_number": "253-503-6001",
            "fax_number": "360-412-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 6TH AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031020",
            "telephone_number": "360-236-7199",
            "fax_number": "360-412-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAEHELI",
        "first_name": "CHRISTOPHER",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.J.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD00026193",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MT",
            "license": "80222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Lacey, WA
• Providers in Lacey, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.