Provider Demographics
NPI:1407205495
Name:HEART, EALA (LMT)
Entity Type:Individual
Prefix:
First Name:EALA
Middle Name:
Last Name:HEART
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8606 N WALL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2034
Mailing Address - Country:US
Mailing Address - Phone:509-489-1544
Mailing Address - Fax:
Practice Address - Street 1:8606 N WALL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2034
Practice Address - Country:US
Practice Address - Phone:509-489-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60527743111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor