Provider Demographics
NPI:1609024942
Name:PALMER, HEATHER A (LMP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:PALMER
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 1:601 S PINE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2793
Mailing Address - Country:US
Mailing Address - Phone:253-396-1000
Mailing Address - Fax:
Practice Address - Street 1:601 S PINE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2793
Practice Address - Country:US
Practice Address - Phone:253-396-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60040412225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist