Provider Demographics
NPI:1316544679
Name:OCHOA, SHAENIAH L
Entity Type:Individual
Prefix:
First Name:SHAENIAH
Middle Name:L
Last Name:OCHOA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1340
Mailing Address - Country:US
Mailing Address - Phone:808-349-7750
Mailing Address - Fax:
Practice Address - Street 1:425 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1340
Practice Address - Country:US
Practice Address - Phone:808-349-7750
Practice Address - Fax:360-863-6508
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC13010171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter