Provider Demographics
NPI:1699973933
Name:HAMMOND, ROCHELE ALDEA (MS, OTL)
Entity type:Individual
Prefix:
First Name:ROCHELE
Middle Name:ALDEA
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:MS, OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5822 60TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-5104
Mailing Address - Country:US
Mailing Address - Phone:425-345-4924
Mailing Address - Fax:425-335-9991
Practice Address - Street 1:5822 60TH ST SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-5104
Practice Address - Country:US
Practice Address - Phone:425-345-4924
Practice Address - Fax:425-335-9991
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001160225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7682891Medicaid