Provider Demographics
NPI:1912106543
Name:HOCH, TARA LYNN (LMP)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:LYNN
Last Name:HOCH
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 1:324 15TH AVE. E
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112
Mailing Address - Country:US
Mailing Address - Phone:206-229-8272
Mailing Address - Fax:
Practice Address - Street 1:324 15TH AVE. E
Practice Address - Street 2:SUITE 204
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112
Practice Address - Country:US
Practice Address - Phone:206-229-8272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA00018521225700000X
WAMA00018521172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00018521OtherDOH LMP IDENTIFIER
WAMA00018521OtherDOH LMP IDENTIFIER