Provider Demographics
NPI:1841353539
Name:COLE, ALICIA MCKENNA (PT)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:MCKENNA
Last Name:COLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2957
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-2957
Mailing Address - Country:US
Mailing Address - Phone:360-509-5824
Mailing Address - Fax:
Practice Address - Street 1:19611 7TH AVENUE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370
Practice Address - Country:US
Practice Address - Phone:360-697-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2022-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist