Provider Demographics
NPI:1609347616
Name:TOOCH, TAHOE (LMT)
Entity Type:Individual
Prefix:MR
First Name:TAHOE
Middle Name:
Last Name:TOOCH
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 BOTHELL EVERETT HWY UNIT 161
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1742
Mailing Address - Country:US
Mailing Address - Phone:425-595-3436
Mailing Address - Fax:425-595-3436
Practice Address - Street 1:16000 BOTHELL EVERETT HWY UNIT 161
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1742
Practice Address - Country:US
Practice Address - Phone:425-595-3436
Practice Address - Fax:425-595-3436
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60288042225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist