Provider Demographics
NPI:1386703437
Name:COE, CHRISTINE A (OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:COE
Suffix:
Gender:F
Credentials:OTR/L
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 183
Mailing Address - Street 2:
Mailing Address - City:NORTH BONNEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98639-0183
Mailing Address - Country:US
Mailing Address - Phone:360-471-2555
Mailing Address - Fax:
Practice Address - Street 1:2901 FALK RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-6392
Practice Address - Country:US
Practice Address - Phone:330-454-3508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003806225X00000X
WAOT00003806225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8398836Medicaid