Provider Demographics
NPI:1720154834
Name:OCHOA, ANNIE K (LMP, CFEP, APP, CCST)
Entity type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:K
Last Name:OCHOA
Suffix:
Gender:F
Credentials:LMP, CFEP, APP, CCST
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:K
Other - Last Name:WALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP, CFEP, APP
Mailing Address - Street 1:1008 126TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-2913
Mailing Address - Country:US
Mailing Address - Phone:206-817-2224
Mailing Address - Fax:
Practice Address - Street 1:3209 S 23RD ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1602
Practice Address - Country:US
Practice Address - Phone:253-581-5200
Practice Address - Fax:253-581-5203
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007355225700000X
WAMA7355174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist