Provider Demographics
NPI:1174964118
Name:OCAMPO, ROXANNE (MA)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-5011
Mailing Address - Country:US
Mailing Address - Phone:360-661-6320
Mailing Address - Fax:
Practice Address - Street 1:927 E FAIRHAVEN AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-1918
Practice Address - Country:US
Practice Address - Phone:360-757-3391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-06
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist