Provider Demographics
NPI:1912205329
Name:OKSENDAHL-BYERS, HEIDI LEMURIA (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:LEMURIA
Last Name:OKSENDAHL-BYERS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:LEMURIA
Other - Last Name:OKSENDAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:914 S. SCHEUBER RD.
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531
Mailing Address - Country:US
Mailing Address - Phone:360-330-8851
Mailing Address - Fax:360-330-8855
Practice Address - Street 1:4833 TUMWATER VALLEY DR.
Practice Address - Street 2:SUITE 150
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501
Practice Address - Country:US
Practice Address - Phone:360-493-4160
Practice Address - Fax:360-493-4163
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60149860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist