Individual
ELIJAH OCCENOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4040 ORCHARD ST W STE 100, FIRCREST, WA 98466-6610
(253) 270-0527
Mailing address
7806 ONYX CT SW, LAKEWOOD, WA 98498-3946
(253) 327-0052
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
01/20/2025
Last updated
01/20/2025
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