Healthcare Provider Details

I. General information

NPI: 1700463387
Provider Name (Legal Business Name): MARIA G OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2021
Last Update Date: 03/28/2021
Certification Date: 03/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 CHAPEL HILL BLVD APT S201
PASCO WA
99301-3492
US

IV. Provider business mailing address

6405 CHAPEL HILL BLVD APT S201
PASCO WA
99301-3492
US

V. Phone/Fax

Practice location:
  • Phone: 509-820-2118
  • Fax:
Mailing address:
  • Phone: 509-820-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number602976590
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: