Individual
HEIDI FENISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1560 3RD AVE, LONGVIEW, WA 98632-3229
(360) 423-9535
(360) 414-9284
Mailing address
1560 3RD AVE, LONGVIEW, WA 98632-3229
(360) 423-9535
(360) 414-9284
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60584686
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60584686
MASSAGE PRACTITIONER LICENSE
WA
Enumeration date
10/07/2015
Last updated
10/07/2015
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