Provider Demographics
NPI:1316519457
Name:OKOCHA, MICHELLE EZINNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:EZINNE
Last Name:OKOCHA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 NW 61ST ST UNIT 408
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5700
Mailing Address - Country:US
Mailing Address - Phone:206-637-5866
Mailing Address - Fax:
Practice Address - Street 1:1407 BROADWAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3854
Practice Address - Country:US
Practice Address - Phone:206-726-3495
Practice Address - Fax:206-726-3498
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61074592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist