Provider Demographics
NPI:1073901948
Name:LAROCHELLE, ULRIKE (LMT)
Entity Type:Individual
Prefix:
First Name:ULRIKE
Middle Name:
Last Name:LAROCHELLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ULI
Other - Middle Name:
Other - Last Name:LAROCHELLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:1375 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3523
Mailing Address - Country:US
Mailing Address - Phone:541-525-3757
Mailing Address - Fax:
Practice Address - Street 1:1375 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3523
Practice Address - Country:US
Practice Address - Phone:541-525-3757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-31
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3341225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist