Individual
MISS HEATHER MARIETTE STEVENSON
Active
Individual
MISS HEATHER MARIETTE STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0400086024
VT
225100000X
Physical Therapist
Primary
PT60392658
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0316277
DEPT. OF LABOR AND INDUSTRIES
WA
05
—
1861749954
—
WA
01
—
P01276067
MEDICARE RAILROAD
WA
Enumeration date
08/08/2012
Last updated
09/10/2015
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