Individual
HEATHER BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
720 S 333RD ST, SUITE 218, FEDERAL WAY, WA 98003-7357
(206) 445-5011
(253) 561-7356
Mailing address
720 S 333RD ST, SUITE 218, FEDERAL WAY, WA 98003-7357
(206) 445-5011
(253) 561-7356
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
13582
OR
172M00000X
Mechanotherapist
Primary
MA00025104
WA
Other
Enumeration date
03/16/2011
Last updated
08/04/2016
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