Provider Demographics
NPI:1356783930
Name:TREMBLY, HEIDI L (LMT)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:L
Last Name:TREMBLY
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 1:2002 NE 177TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-0771
Mailing Address - Country:US
Mailing Address - Phone:360-823-7114
Mailing Address - Fax:
Practice Address - Street 1:316 SE 123RD AVE STE A6-2
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-4056
Practice Address - Country:US
Practice Address - Phone:360-823-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60378624225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist