Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00017808 | WA |
NPI | 1013179092 |
---|---|
Provider Name | Heidi Nader |
First Address | Tacoma, WA 98407-5608 |
Second Address | Puyallup, WA 98375-6286 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 08/07/2008 |