Provider Demographics
NPI:1942490727
Name:UDDIN, KRISTY (OTD, OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:UDDIN
Suffix:
Gender:F
Credentials:OTD, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 MONTE VILLA PKWY
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-8972
Mailing Address - Country:US
Mailing Address - Phone:425-408-6000
Mailing Address - Fax:
Practice Address - Street 1:3330 MONTE VILLA PKWY
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-8972
Practice Address - Country:US
Practice Address - Phone:425-408-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00004011225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2751UDOtherREGENCE
WA0004UDOtherREGENCE
WA4011UDOtherREGENCE
WA3160UDOtherREGENCE
WA8432981OtherDSHS
WA4161UDOtherREGENCE
WA8949374OtherL&I CRIME
WA1061UDOtherREGENCE
WA2494UDOtherREGENCE
WA0241665OtherL&I
WA8948594OtherL&I CRIME
WA0239979OtherL&I
WA1942UDOtherREGENCE
WA0004UDOtherREGENCE
WAG8904974Medicare PIN
WAG8876550Medicare PIN
WA2494UDOtherREGENCE