Healthcare Provider Details

I. General information

NPI: 1346635489
Provider Name (Legal Business Name): CODY COLE LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 5TH AVE NW STE 300
ISSAQUAH WA
98027-2845
US

IV. Provider business mailing address

710 5TH AVE NW STE 300
ISSAQUAH WA
98027-2845
US

V. Phone/Fax

Practice location:
  • Phone: 425-998-6542
  • Fax: 425-332-7071
Mailing address:
  • Phone: 425-998-6542
  • Fax: 425-332-7071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC70066965
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60555501
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: