Provider Demographics
NPI:1023824141
Name:CACHO-RIVERA, PAMELA ANN (LMT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:CACHO-RIVERA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 S 29TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66106-2133
Mailing Address - Country:US
Mailing Address - Phone:913-689-8891
Mailing Address - Fax:
Practice Address - Street 1:1428 S 29TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106-2133
Practice Address - Country:US
Practice Address - Phone:913-689-8891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist