Provider Demographics
NPI:1093064610
Name:GARCIA OCHOA, ALEJANDRO L
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:L
Last Name:GARCIA OCHOA
Suffix:
Gender:M
Credentials:
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 3397
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98063-3397
Mailing Address - Country:US
Mailing Address - Phone:206-592-6914
Mailing Address - Fax:
Practice Address - Street 1:31731 3RD PL SW
Practice Address - Street 2:APT 38C
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-4836
Practice Address - Country:US
Practice Address - Phone:206-592-6914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC15939171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMC15939OtherDSHS