Individual
HEIDI MELISSA KIFOWIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
128 D ST SW, TUMWATER, WA 98501-4064
(360) 570-9580
Mailing address
128 D ST SW, TUMWATER, WA 98501-4064
(360) 570-9580
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00021663
WA
Other
Enumeration date
12/20/2006
Last updated
11/14/2009
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