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General NPI Number Information
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NPI Number | 1356783930
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Entity Type | Individual
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Provider Name | HEIDI L TREMBLY LMT
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Gender | Female
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 316 SE 123RD AVE STE A6-2
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City | VANCOUVER
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State | WA
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Zip | 98683-4056
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Country | US
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Telephone | 360-823-7114
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Fax |
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Provider Business Mailing Address
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Address Line | 2002 NE 177TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98684-0771
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Country | US
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Telephone | 360-823-7114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60378624
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License Number State | WA
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