Provider Demographics
NPI:1265488761
Name:CODDINGTON, CHERYL T (OTRL)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:T
Last Name:CODDINGTON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:T
Other - Last Name:LAUFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:7704 BRIDGEPORT WAY W
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8380
Mailing Address - Country:US
Mailing Address - Phone:253-581-9410
Mailing Address - Fax:253-581-9207
Practice Address - Street 1:7704 BRIDGEPORT WAY W
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8380
Practice Address - Country:US
Practice Address - Phone:253-458-1941
Practice Address - Fax:253-581-9207
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003356225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5743COOtherREGENCE BLUESHIELD
WA153902OtherLABOR & INDUSTRIES
WA8346793Medicaid
WAAB24362Medicare ID - Type Unspecified
WA670002208Medicare ID - Type UnspecifiedRAILROAD MEDICARE