Basic Information
| Provider Information | |||||||||
| NPI: | 1114565850 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | EGBUZIE | ||||||||
| FirstName: | TOCHI | ||||||||
| MiddleName: | ONYEKACHI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15009 12TH PL W UNIT E | ||||||||
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| City: | LYNNWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980874507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3236411962 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11700 MUKILTEO SPEEDWAY STE 503 | ||||||||
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| City: | MUKILTEO | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982755444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253499692 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2019 | ||||||||
| LastUpdateDate: | 12/12/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/12/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 61016698 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.