Provider Demographics
NPI:1780900811
Name:BILLINGS, HEIDI MAY (LMP)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:MAY
Last Name:BILLINGS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12102 4TH AVE W APT 18-301
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5789
Mailing Address - Country:US
Mailing Address - Phone:602-617-1228
Mailing Address - Fax:
Practice Address - Street 1:3231 RUCKER AVE STE A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4224
Practice Address - Country:US
Practice Address - Phone:425-252-3127
Practice Address - Fax:425-252-3128
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60141285225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist