Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT10156 | WA |
NPI | 1073685178 |
---|---|
Provider Name | Aaryn Hieb |
First Address | Spokane, WA 99208-7395 |
Second Address | Spokane, WA 99208-7395 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 22/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8458879 | (05) | WA |