Provider Demographics
NPI:1457575839
Name:COCHRAN, KRISTEN NOELLE (LMP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:NOELLE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8216 GREENWOOD AVE N APT 5
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4200
Mailing Address - Country:US
Mailing Address - Phone:206-353-5332
Mailing Address - Fax:
Practice Address - Street 1:469 N 36TH ST STE C
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8671
Practice Address - Country:US
Practice Address - Phone:206-547-1104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016736225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist