Provider Demographics
NPI:1619550100
Name:BIDWELL, HANNAH JOY (LMT)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:JOY
Last Name:BIDWELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:HANNAH
Other - Middle Name:JOY
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:WA
Mailing Address - Zip Code:99102-0421
Mailing Address - Country:US
Mailing Address - Phone:509-595-9043
Mailing Address - Fax:
Practice Address - Street 1:110 N H ST.
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:WA
Practice Address - Zip Code:99102-0421
Practice Address - Country:US
Practice Address - Phone:509-595-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMAS-4238225700000X
WAMA61094830225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist