Provider Demographics
NPI:1831542125
Name:BARRETT M. ROCHEFORT
Entity type:Organization
Organization Name:BARRETT M. ROCHEFORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRETT
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROCHEFORT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-284-4505
Mailing Address - Street 1:2046 WESTLAKE AVE N
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2700
Mailing Address - Country:US
Mailing Address - Phone:206-284-4505
Mailing Address - Fax:206-284-4757
Practice Address - Street 1:2046 WESTLAKE AVE N
Practice Address - Street 2:SUITE 204
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2700
Practice Address - Country:US
Practice Address - Phone:206-284-4505
Practice Address - Fax:206-284-4757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA41511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty