Provider Demographics
NPI:1912229345
Name:GREB, HELAINA (LMP)
Entity Type:Individual
Prefix:
First Name:HELAINA
Middle Name:
Last Name:GREB
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:PO BOX 1364
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-1364
Mailing Address - Country:US
Mailing Address - Phone:360-400-0850
Mailing Address - Fax:
Practice Address - Street 1:7525 STATE ROUTE 702 S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:WA
Practice Address - Zip Code:98580-9211
Practice Address - Country:US
Practice Address - Phone:360-400-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022210225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist