Provider Demographics
NPI:1649780792
Name:KOBE, KRISTA BETH
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:BETH
Last Name:KOBE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KRISTA
Other - Middle Name:BETH
Other - Last Name:KOBE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:43411 SE 76TH ST
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9410
Mailing Address - Country:US
Mailing Address - Phone:206-790-2209
Mailing Address - Fax:
Practice Address - Street 1:16250 NE 74TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7817
Practice Address - Country:US
Practice Address - Phone:425-936-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60581676235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist