Healthcare Provider Details

I. General information

NPI: 1508008962
Provider Name (Legal Business Name): KATHERINE ANN HUFF LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 12/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12202 PACIFIC AVE S SUITE A
TACOMA WA
98444-5157
US

IV. Provider business mailing address

12202 PACIFIC AVE S SUITE A
TACOMA WA
98444-5157
US

V. Phone/Fax

Practice location:
  • Phone: 253-212-9956
  • Fax:
Mailing address:
  • Phone: 253-212-9956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60077010
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: