Individual
CHRISTA I HUDDLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5210 CORPORATE CENTER CT. S.E., SUITE D, LACEY, WA 98503
(360) 455-8155
(360) 455-1655
Mailing address
5210 CORPORATE CENTER LOOP SE, SUITE D, LACEY, WA 98503-5952
(360) 455-8155
(360) 455-1655
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00001210
WA
225XH1200X
Hand Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202611
DEPT. OF LABOR & INDUSTRY
WA
01
—
3456HU
REGENCE BLUE SHIELD
WA
01
—
7029729
AETNA
WA
01
—
710883456-98503-A002
TRICARE
WA
05
—
8439135
—
WA
01
—
8937988
L&I CRIME VICTIMS
WA
Enumeration date
04/20/2006
Last updated
04/15/2010
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