Provider Demographics
NPI:1821334889
Name:REYNOLDS, CHRISTINE E (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:E
Last Name:REYNOLDS
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 1:506 NW 203RD ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-2045
Mailing Address - Country:US
Mailing Address - Phone:206-542-3916
Mailing Address - Fax:
Practice Address - Street 1:506 NW 203RD ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-2045
Practice Address - Country:US
Practice Address - Phone:206-542-3916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00000504225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist