Provider Demographics
NPI:1467753244
Name:COHEN, TOBY JOSHUA (LMP)
Entity Type:Individual
Prefix:MR
First Name:TOBY
Middle Name:JOSHUA
Last Name:COHEN
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 NE 7TH ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3619
Mailing Address - Country:US
Mailing Address - Phone:206-383-9875
Mailing Address - Fax:
Practice Address - Street 1:2307 NE 7TH ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-3619
Practice Address - Country:US
Practice Address - Phone:206-383-9875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60190457225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist