Provider Demographics
NPI:1427498310
Name:FISHER, KRISTINA M (OTR/L)
Entity type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:M
Last Name:FISHER
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 1:598 FALSE BAY DR
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-8494
Mailing Address - Country:US
Mailing Address - Phone:360-370-0016
Mailing Address - Fax:
Practice Address - Street 1:598 FALSE BAY DR
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-8494
Practice Address - Country:US
Practice Address - Phone:360-370-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist