Healthcare Provider Details

I. General information

NPI: 1376863084
Provider Name (Legal Business Name): HEART, HANDS & HUES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39511 NE CHRISTENSEN RD
LA CENTER WA
98629-4764
US

IV. Provider business mailing address

39511 NE CHRISTENSEN RD
LA CENTER WA
98629-4764
US

V. Phone/Fax

Practice location:
  • Phone: 360-263-7423
  • Fax:
Mailing address:
  • Phone: 360-263-7423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA00023418
License Number StateWA

VIII. Authorized Official

Name: JEANNIE A. GILBERT
Title or Position: OWNER
Credential: LMP
Phone: 360-263-7423