Provider Demographics
NPI:1669742557
Name:OCAMPO, CLAUDINA
Entity type:Individual
Prefix:MRS
First Name:CLAUDINA
Middle Name:
Last Name:OCAMPO
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 1:1607 RIVER RD
Mailing Address - Street 2:APT #1
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-6227
Mailing Address - Country:US
Mailing Address - Phone:509-577-7116
Mailing Address - Fax:
Practice Address - Street 1:1607 RIVER RD
Practice Address - Street 2:APT #1
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-6227
Practice Address - Country:US
Practice Address - Phone:509-577-7116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00058690164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA164W00000XMedicaid