Provider Demographics
NPI:1841802089
Name:ROCKER, NATALIE ANN (MA60584485)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:ROCKER
Suffix:
Gender:F
Credentials:MA60584485
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 TELEGRAPH RD UNIT 203
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-7783
Mailing Address - Country:US
Mailing Address - Phone:509-881-1526
Mailing Address - Fax:
Practice Address - Street 1:1704 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4605
Practice Address - Country:US
Practice Address - Phone:360-922-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60584485225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist