Provider Demographics
NPI:1730054388
Name:PACHECO, JAREKA JOLENE
Entity type:Individual
Prefix:
First Name:JAREKA
Middle Name:JOLENE
Last Name:PACHECO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S 7TH AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3385
Mailing Address - Country:US
Mailing Address - Phone:509-453-1420
Mailing Address - Fax:509-453-1453
Practice Address - Street 1:107 S 7TH AVE STE 203
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3385
Practice Address - Country:US
Practice Address - Phone:509-453-1420
Practice Address - Fax:509-453-1453
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMASS.MA.70048640225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist