Provider Demographics
NPI:1780834689
Name:SCHOCH, GREG JEROME (ME, MRE)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:JEROME
Last Name:SCHOCH
Suffix:
Gender:M
Credentials:ME, MRE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 N NORTHGATE WAY
Mailing Address - Street 2:SUITE 217
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9018
Mailing Address - Country:US
Mailing Address - Phone:206-371-3536
Mailing Address - Fax:
Practice Address - Street 1:2111 N NORTHGATE WAY
Practice Address - Street 2:SUITE 217
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9018
Practice Address - Country:US
Practice Address - Phone:206-371-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00045163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health