Provider Demographics
NPI:1366587305
Name:HUGHES, HEATHER ANNE (LMP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANNE
Other - Last Name:HOGLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:413 BATES ST SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4055
Mailing Address - Country:US
Mailing Address - Phone:360-956-0599
Mailing Address - Fax:360-705-2708
Practice Address - Street 1:413 BATES ST SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4055
Practice Address - Country:US
Practice Address - Phone:360-956-0599
Practice Address - Fax:360-705-2708
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021052225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0224872OtherDEPT OF L & I
WA0198054OtherDEPT OF L&I