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General NPI Number Information
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NPI Number | 1922182864
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Entity Type | Individual
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Provider Name | HEATHER M ROSENTHAL LMP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 11/21/2012
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Provider Practice Location Address
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Address Line | 12310 N DIVISION ST STE. 105
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City | SPOKANE
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State | WA
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Zip | 99218-1998
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Country | US
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Telephone | 509-466-1117
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Fax | 509-464-0578
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Provider Business Mailing Address
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Address Line | PO BOX 233
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City | CHATTAROY
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State | WA
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Zip | 99003-0233
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Country | US
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Telephone | 509-220-5505
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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 | MA00014727
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License Number State | WA
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