Provider Demographics
NPI:1750687026
Name:KOLBECK, LEANA JEAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:LEANA
Middle Name:JEAN
Last Name:KOLBECK
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 1:910 8TH AVE
Mailing Address - Street 2:APT #1005
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1225
Mailing Address - Country:US
Mailing Address - Phone:602-377-2283
Mailing Address - Fax:
Practice Address - Street 1:910 8TH AVE
Practice Address - Street 2:APT #1005
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1225
Practice Address - Country:US
Practice Address - Phone:602-377-2283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 60113755225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation