| NPI | 1679888705 |
|---|---|
| Former Name | HEATHER A FISHBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: WA 60129779) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60129779) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2017-07-21 |