Provider Demographics
NPI:1225291131
Name:OCHOA, JUAN PABLO (LMP)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:PABLO
Last Name:OCHOA
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 W KENNEWICK AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-3377
Mailing Address - Country:US
Mailing Address - Phone:509-582-3549
Mailing Address - Fax:509-531-6687
Practice Address - Street 1:1721 W KENNEWICK AVE STE 1
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3377
Practice Address - Country:US
Practice Address - Phone:509-582-3549
Practice Address - Fax:509-531-6687
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024826225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist