Provider Demographics
NPI:1124133434
Name:COBBLEY, JOSH D (OTR)
Entity type:Individual
Prefix:MR
First Name:JOSH
Middle Name:D
Last Name:COBBLEY
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16419 SAYBROOK DR NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-7475
Mailing Address - Country:US
Mailing Address - Phone:425-788-7385
Mailing Address - Fax:
Practice Address - Street 1:16419 SAYBROOK DR NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-7475
Practice Address - Country:US
Practice Address - Phone:425-788-7385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4085OtherLICENSE #