Basic Information
| Provider Information | |||||||||
| NPI: | 1982868824 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOSE | ||||||||
| FirstName: | KRISTINE | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 141 W 8TH ST | ||||||||
| Address2: | |||||||||
| City: | WAHOO | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680661603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026772455 | ||||||||
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| Practice Location | |||||||||
| Address1: | 729 HENDERSON RD | ||||||||
| Address2: | |||||||||
| City: | HOOD RIVER | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970318772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413862688 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2008 | ||||||||
| LastUpdateDate: | 07/10/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.