Provider Demographics
NPI:1821567322
Name:COCHRAN, KRISTIN RAE (MA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:RAE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 W GARLAND AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-2615
Mailing Address - Country:US
Mailing Address - Phone:509-903-8596
Mailing Address - Fax:
Practice Address - Street 1:1414 W GARLAND AVE STE 108
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-2615
Practice Address - Country:US
Practice Address - Phone:509-903-8596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60882324106H00000X
WA61070816106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist