Healthcare Provider Details

I. General information

NPI: 1275562449
Provider Name (Legal Business Name): CHRISTOPHER BOCKER OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11400 SE 6TH ST STE 105
BELLEVUE WA
98004-6419
US

IV. Provider business mailing address

11400 SE 6TH ST STE 105
BELLEVUE WA
98004-6419
US

V. Phone/Fax

Practice location:
  • Phone: 206-448-1906
  • Fax:
Mailing address:
  • Phone: 206-448-1906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2066
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: