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General NPI Number Information
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NPI Number | 1922211002
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Entity Type | Individual
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Provider Name | HEIDI A CHRISMAN L.M.P.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5015 VARCO RD NE
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City | TACOMA
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State | WA
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Zip | 98422-1805
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Country | US
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Telephone | 253-719-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 TOWN CTR NE STE 180 PMB #124
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City | TACOMA
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State | WA
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Zip | 98422-1194
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Country | US
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Telephone | 253-719-0444
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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 | MA00012231
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License Number State | WA
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