Provider Demographics
NPI:1467873356
Name:LIENHARD, VALLERIE (MA60406904)
Entity Type:Individual
Prefix:
First Name:VALLERIE
Middle Name:
Last Name:LIENHARD
Suffix:
Gender:F
Credentials:MA60406904
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1113
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-1113
Mailing Address - Country:US
Mailing Address - Phone:785-556-1270
Mailing Address - Fax:
Practice Address - Street 1:8208 243RD STREET CT E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-7305
Practice Address - Country:US
Practice Address - Phone:785-556-1270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60406904172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist