Provider Demographics
NPI:1629232657
Name:HARLAN, VERONICA HELEN (LMP)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:HELEN
Last Name:HARLAN
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 1:19255 POWDER HILL PL NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7455
Mailing Address - Country:US
Mailing Address - Phone:360-697-3003
Mailing Address - Fax:360-697-3026
Practice Address - Street 1:19255 POWDER HILL PL NE
Practice Address - Street 2:SUITE 200
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7455
Practice Address - Country:US
Practice Address - Phone:360-697-3003
Practice Address - Fax:360-697-3026
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019819225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist