Healthcare Provider Details

I. General information

NPI: 1518183342
Provider Name (Legal Business Name): PATRICIA A HIGGINS LMP, RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14467 WOODINVILLE REDMOND RD NE
WOODINVILLE WA
98072-9095
US

IV. Provider business mailing address

12918 NE 136TH ST
KIRKLAND WA
98034-2342
US

V. Phone/Fax

Practice location:
  • Phone: 425-485-4003
  • Fax:
Mailing address:
  • Phone: 425-820-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA00006096
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: