Provider Demographics
NPI:1518383793
Name:GALLOWAY, HEATHER (EAMP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9962 MARCH MIST CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-3540
Mailing Address - Country:US
Mailing Address - Phone:206-724-6819
Mailing Address - Fax:
Practice Address - Street 1:2760 LAKE SAHARA DR STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3438
Practice Address - Country:US
Practice Address - Phone:206-724-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2025171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist