Provider Demographics
NPI:1225590128
Name:FRAHM, KRISTA SUE (OT)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:SUE
Last Name:FRAHM
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:SUE
Other - Last Name:EGGERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:503 E HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHELAN
Mailing Address - State:WA
Mailing Address - Zip Code:98816-8631
Mailing Address - Country:US
Mailing Address - Phone:509-726-6041
Mailing Address - Fax:509-682-9614
Practice Address - Street 1:503 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-8631
Practice Address - Country:US
Practice Address - Phone:509-726-6041
Practice Address - Fax:509-682-9614
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60137602225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOT60137602OtherSTATE OF WASHINGTON MEDICAL LICENSE