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NPI Code Detail

MEDICARE: ELLEN A ROCHON LMT

MEDICARE:   ELLEN A ROCHON  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMA00021494WA

General Provider Information

NPI Number : 1013276906
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN A ROCHON LMT
Provider Business Mailing Address
First Line : 820 OCEAN BEACH HWY STE 116
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-4081
Country : US
Telephone Number : 360-414-3220
Fax Number : 360-353-5350
Provider Business Practice Location Address
First Line : 820 OCEAN BEACH HWY STE 116
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-4081
Country : US
Telephone Number : 360-414-3220
Fax Number : 360-353-5350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2012
Last Update Date : 02/13/2015

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Directions to “ ELLEN A ROCHON LMT” Practice Location

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