Provider Demographics
NPI:1003177718
Name:OCHILTRE, ANNALISA (MS)
Entity type:Individual
Prefix:
First Name:ANNALISA
Middle Name:
Last Name:OCHILTRE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LISA
Other - Last Name:KEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2333 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-4656
Mailing Address - Country:US
Mailing Address - Phone:360-472-0528
Mailing Address - Fax:360-653-8028
Practice Address - Street 1:2333 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-4656
Practice Address - Country:US
Practice Address - Phone:360-472-0528
Practice Address - Fax:360-653-8028
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60512430101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1003177718Medicaid