Provider Demographics
NPI:1407132715
Name:OCHESKE, CHRISTIE LEILANI (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:LEILANI
Last Name:OCHESKE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2225
Mailing Address - Country:US
Mailing Address - Phone:503-420-2088
Mailing Address - Fax:
Practice Address - Street 1:317 1ST AVE W
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2225
Practice Address - Country:US
Practice Address - Phone:503-420-2088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17498171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor