Individual
ROCHELL R. KOSTELECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 403-8327
Mailing address
PO BOX 5215, TACOMA, WA 98415-0215
(253) 403-8327
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60700601
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2071177
—
WA
Enumeration date
07/17/2015
Last updated
04/08/2020
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