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Individual

BARBARA HEINTZ MCDANIEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BS, LMP

Contact information

Practice address
311 STEVENS AVE., SULTAN, WA 98294
(360) 793-1122
(360) 677-2233
Mailing address
PO BOX 1415, SULTAN, WA 98294-1415
(360) 793-1122
(360) 677-2233

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00007520
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA00007520
MASSAGE LICENSE
WA
Enumeration date
11/20/2006
Last updated
07/08/2007
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