Provider Demographics
NPI:1730666231
Name:OROSCO, ANGELICA (LMT)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:OROSCO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-9407
Mailing Address - Country:US
Mailing Address - Phone:509-402-9020
Mailing Address - Fax:509-402-9036
Practice Address - Street 1:403 N EUCLID ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-9407
Practice Address - Country:US
Practice Address - Phone:509-402-9020
Practice Address - Fax:509-402-9036
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB60925764106S00000X
WAMA61408743225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician