Provider Demographics
NPI:1679837157
Name:COLO, CHRISTINA LEE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:LEE
Last Name:COLO
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 1:2085 INLAND DR STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-1203
Mailing Address - Country:US
Mailing Address - Phone:541-267-5221
Mailing Address - Fax:
Practice Address - Street 1:2085 INLAND DR STE A
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-1203
Practice Address - Country:US
Practice Address - Phone:541-267-5221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR978043174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist