Provider Demographics
NPI:1760489918
Name:JECHA, LARRY D (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:D
Last Name:JECHA
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7102 W. OKANOGAN PLACE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336
Mailing Address - Country:US
Mailing Address - Phone:509-460-4550
Mailing Address - Fax:509-460-4590
Practice Address - Street 1:7102 W. OKANOGAN PLACE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336
Practice Address - Country:US
Practice Address - Phone:509-460-4550
Practice Address - Fax:509-460-4590
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA025209 MD000256692083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8109746Medicaid
WA8109746Medicaid
WAGAB33791Medicare PIN