Provider Demographics
NPI:1437130010
Name:TORKLEP, CHENOA A (LMP)
Entity Type:Individual
Prefix:
First Name:CHENOA
Middle Name:A
Last Name:TORKLEP
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:CHENOA
Other - Middle Name:A
Other - Last Name:CHELSEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:PO BOX 582
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-0582
Mailing Address - Country:US
Mailing Address - Phone:253-208-7657
Mailing Address - Fax:
Practice Address - Street 1:2748 MILTON WAY
Practice Address - Street 2:SUITE # 211
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-9382
Practice Address - Country:US
Practice Address - Phone:253-208-7657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021429225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist