Individual
DR. JAY RANDALL COCHEBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1617 E DIVISION ST, MOUNT VERNON, WA 98274-4503
(360) 424-4466
(360) 208-0564
Mailing address
1617 E DIVISION ST, MOUNT VERNON, WA 98274-4503
(360) 424-4466
(360) 208-0564
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000773
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0264542
L&I
WA
05
—
1016127
—
WA
Enumeration date
07/25/2006
Last updated
07/21/2022
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