Individual
HEIDI GRACE STOCKBAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
603 HUNT AVE, SUMNER, WA 98390-1117
(253) 863-0855
Mailing address
603 HUNT AVE, SUMNER, WA 98390-1117
(253) 863-0855
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
60953289
WA
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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