Provider Demographics
NPI:1518183342
Name:HIGGINS, PATRICIA A (LMP, RBT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LMP, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12918 NE 136TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2342
Mailing Address - Country:US
Mailing Address - Phone:425-820-2552
Mailing Address - Fax:
Practice Address - Street 1:14467 WOODINVILLE REDMOND RD NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-9095
Practice Address - Country:US
Practice Address - Phone:425-485-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006096172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist