Provider Demographics
NPI:1467782573
Name:CHOCIEJ, MATTHEW RICHARD (LMP)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:RICHARD
Last Name:CHOCIEJ
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 1:220 M ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4427
Mailing Address - Country:US
Mailing Address - Phone:253-333-8736
Mailing Address - Fax:
Practice Address - Street 1:220 M ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4427
Practice Address - Country:US
Practice Address - Phone:253-333-8736
Practice Address - Fax:253-735-0902
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024913225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist