Provider Demographics
NPI:1841406527
Name:COSLEY, KRISTINA MOSER (PT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MOSER
Last Name:COSLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:LYNN
Other - Last Name:MOSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1621 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3019
Mailing Address - Country:US
Mailing Address - Phone:970-946-1855
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:BOX 359920
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-521-1675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30267225100000X
WAPT00009000225100000X
IN05007760A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist