Provider Demographics
NPI:1891032561
Name:COLE, ADRIENNE LOUISE (RPT)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:LOUISE
Last Name:COLE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 WHITMAN ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3120
Mailing Address - Country:US
Mailing Address - Phone:509-520-1448
Mailing Address - Fax:
Practice Address - Street 1:364 S PARK ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3249
Practice Address - Country:US
Practice Address - Phone:509-520-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003703174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist