Provider Demographics
NPI:1457843047
Name:LUCHI, MADI ANN (LMP)
Entity Type:Individual
Prefix:
First Name:MADI
Middle Name:ANN
Last Name:LUCHI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 SE WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3049
Mailing Address - Country:US
Mailing Address - Phone:253-508-7850
Mailing Address - Fax:
Practice Address - Street 1:1270 SW WILLIAM AVE
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-4730
Practice Address - Country:US
Practice Address - Phone:253-508-7850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist