Provider Demographics
NPI:1154120988
Name:CIOCAZAN, MARIA MAGDA (LMT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MAGDA
Last Name:CIOCAZAN
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-1013
Mailing Address - Country:US
Mailing Address - Phone:208-304-7285
Mailing Address - Fax:208-758-8527
Practice Address - Street 1:827 W PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-8459
Practice Address - Country:US
Practice Address - Phone:208-660-9378
Practice Address - Fax:208-758-8527
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMASG-677225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist