Provider Demographics
NPI:1124198346
Name:OWENS, HEATHER CHISHOLM (LMP CIMI)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CHISHOLM
Last Name:OWENS
Suffix:
Gender:F
Credentials:LMP CIMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 227TH ST SW
Mailing Address - Street 2:
Mailing Address - City:BRIER
Mailing Address - State:WA
Mailing Address - Zip Code:98036
Mailing Address - Country:US
Mailing Address - Phone:206-660-0907
Mailing Address - Fax:206-675-1043
Practice Address - Street 1:5355 TALLMAN AVE NW STE 214
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3935
Practice Address - Country:US
Practice Address - Phone:206-660-0907
Practice Address - Fax:206-675-1043
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007470225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist