Provider Demographics
NPI:1598945578
Name:ROSEN, KRISTIN M (OTR/L, CHT, CLT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:ROSEN
Suffix:
Gender:F
Credentials:OTR/L, CHT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:1810 116TH AVE NE
Practice Address - Street 2:SUITE D-4
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3058
Practice Address - Country:US
Practice Address - Phone:425-283-5230
Practice Address - Fax:425-283-5236
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003373225XH1200X
WA00003373225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand