Provider Demographics
NPI:1578588505
Name:KUCHAR, PATRICIA ANN (LAC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:KUCHAR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:KUCHAR-HAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:3554 OLD PACIFIC HWY S
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626
Mailing Address - Country:US
Mailing Address - Phone:360-636-0991
Mailing Address - Fax:360-636-5255
Practice Address - Street 1:1328 9TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632
Practice Address - Country:US
Practice Address - Phone:360-636-0991
Practice Address - Fax:360-636-5255
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist