Provider Demographics
NPI:1205376944
Name:BRACHER, HEIDI ANNE
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANNE
Last Name:BRACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:ANNE
Other - Last Name:BRACHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:5370 WILSON AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2566
Mailing Address - Country:US
Mailing Address - Phone:206-446-3443
Mailing Address - Fax:
Practice Address - Street 1:5370 WILSON AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2566
Practice Address - Country:US
Practice Address - Phone:206-446-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015963225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist