Provider Demographics
NPI:1922494954
Name:COBLE, CHRISTINE M (OT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:COBLE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1723 NE 179TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-3977
Mailing Address - Country:US
Mailing Address - Phone:206-465-6146
Mailing Address - Fax:
Practice Address - Street 1:1723 NE 179TH ST APT 6
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-3977
Practice Address - Country:US
Practice Address - Phone:206-465-6146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00000798225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist