Provider Demographics
NPI:1033425202
Name:HEIDI NADER, LMP, LLC
Entity Type:Organization
Organization Name:HEIDI NADER, LMP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:NADER
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-376-3456
Mailing Address - Street 1:3015 39TH STREET CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8574
Mailing Address - Country:US
Mailing Address - Phone:253-376-3456
Mailing Address - Fax:253-604-0861
Practice Address - Street 1:13909 MERIDIAN E
Practice Address - Street 2:SUITE A2
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-9180
Practice Address - Country:US
Practice Address - Phone:253-604-0350
Practice Address - Fax:253-604-0861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017808225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty