Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00022463 | WA |
NPI | 1003035908 |
---|---|
Provider Name | Heather Joy Mccombs |
First Address | Auburn, WA 98002-8018 |
Second Address | Federal Way, WA 98003-8505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 08/07/2007 |