Provider Demographics
NPI:1891838967
Name:ROCHON, MORGAN HEATHER (LMP)
Entity Type:Individual
Prefix:MISS
First Name:MORGAN
Middle Name:HEATHER
Last Name:ROCHON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 TACOMA AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-4308
Mailing Address - Country:US
Mailing Address - Phone:360-876-6632
Mailing Address - Fax:
Practice Address - Street 1:5122 OLYMPIC DR NW
Practice Address - Street 2:SUITE A-102
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1767
Practice Address - Country:US
Practice Address - Phone:253-858-5152
Practice Address - Fax:253-858-5153
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022627225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0213120OtherLABOR AND INDUSTRIES