Provider Demographics
NPI:1528216132
Name:HEATON, ANNA MARIE (LMP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:HEATON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6511 23RD AVE NE
Mailing Address - Street 2:APT 2
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6051
Mailing Address - Country:US
Mailing Address - Phone:206-755-7987
Mailing Address - Fax:
Practice Address - Street 1:6511 23RD AVE NE
Practice Address - Street 2:APT 2
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6051
Practice Address - Country:US
Practice Address - Phone:206-755-7987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00025178225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist