Provider Demographics
NPI:1174396386
Name:HUNT, MIA Z (LMT)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:Z
Last Name:HUNT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 E 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3425
Mailing Address - Country:US
Mailing Address - Phone:509-270-7148
Mailing Address - Fax:
Practice Address - Street 1:1106 N WASHINGTON ST STE D
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2205
Practice Address - Country:US
Practice Address - Phone:509-795-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60625875225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist