Basic Information
| Provider Information | |||||||||
| NPI: | 1669492419 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OCHIAI | ||||||||
| FirstName: | TOMOYUKI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 709 W ORCHARD DR | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982251766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603188800 | ||||||||
| FaxNumber: | 3603181085 | ||||||||
| Practice Location | |||||||||
| Address1: | 3130 SQUALICUM PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982251940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607560382 | ||||||||
| FaxNumber: | 3607565184 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 05/30/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD00038611 | WA | N | Allopathic & Osteopathic Physicians | Surgery | 207Q00000X | MD00038611 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0291648 | 01 | WA | LABOR AND INDUSTRIES | OTHER |