Provider Demographics
NPI:1891920930
Name:HUSH, HEATHER LIND (LMT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LIND
Last Name:HUSH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LIND
Other - Last Name:SQUIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:10513 SILVERDALE WAY NW #D4
Mailing Address - Street 2:RELAX MASSAGE
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-692-5577
Mailing Address - Fax:
Practice Address - Street 1:10513 SILVERDALE WAY NW # D4
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9499
Practice Address - Country:US
Practice Address - Phone:360-692-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60059786225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist