Provider Demographics
NPI:1164772018
Name:CONLEY, KRISTI ALANA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:ALANA
Last Name:CONLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13011 E. DEER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHATTAROY
Mailing Address - State:WA
Mailing Address - Zip Code:99003-7001
Mailing Address - Country:US
Mailing Address - Phone:509-951-3012
Mailing Address - Fax:
Practice Address - Street 1:13011 E DEER CREEK RD
Practice Address - Street 2:
Practice Address - City:CHATTAROY
Practice Address - State:WA
Practice Address - Zip Code:99003-7001
Practice Address - Country:US
Practice Address - Phone:509-951-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00004028172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker