MEDICARE: HEATHER SALISBURY MA60294771

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA60294771	WA

General Provider Information

NPI Number	:	1407268683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER SALISBURY MA60294771

Provider Business Mailing Address
First Line	:	1303 4TH AVE E
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-4245
Country	:	US
Telephone Number	:	360-357-5170
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 4TH AVE E
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-4245
Country	:	US
Telephone Number	:	360-357-5170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	05/22/2014

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