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Individual

HEATHER DIANNE DUFFEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP, ATC AT/L

Contact information

Practice address
104 GROVER ST, LYNDEN, WA 98264-1409
(360) 410-4102
Mailing address
801 MAIN ST, LYNDEN, WA 98264-1300
(360) 410-4102

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
A1600045323
WA
225700000X
Massage Therapist
Primary
MA00021912
WA

Other

Enumeration date
07/22/2010
Last updated
07/22/2010
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