Provider Demographics
NPI:1710321153
Name:MCARTHUR, ROBERTA (LMT)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:MCARTHUR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20407 NE 259TH ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-6909
Mailing Address - Country:US
Mailing Address - Phone:360-687-1785
Mailing Address - Fax:
Practice Address - Street 1:44-740 PUAMOHALA ST
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2453
Practice Address - Country:US
Practice Address - Phone:808-224-7461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-9573225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist