Provider Demographics
NPI:1346615978
Name:HECTOR, TAWNESHA R (LMT)
Entity Type:Individual
Prefix:
First Name:TAWNESHA
Middle Name:R
Last Name:HECTOR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15858 1ST AVE SOUTH
Mailing Address - Street 2:SUITE A104
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148
Mailing Address - Country:US
Mailing Address - Phone:206-838-0022
Mailing Address - Fax:206-838-0021
Practice Address - Street 1:15858 1ST AVE SOUTH
Practice Address - Street 2:SUITE A104
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148
Practice Address - Country:US
Practice Address - Phone:206-838-0022
Practice Address - Fax:206-838-0021
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMA60247275225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist