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Contact Information

HEATHER BLACK, LMP
720 S 333RD ST
SUITE 218
FEDERAL WAY, WA98003-7357
 Phone: 206-445-5011
 Fax: 253-561-7356
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mechanotherapist

172M00000X
Indicates primary specialty

NPI Profile & details for HEATHER BLACK · (Female)

NPI # 1619276615
Status Active
Credentials LMP (Licensed Medical Practitioner)
Entity Individual
Enumeration date 03/16/2011
Last updated 08/04/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # 13582
  • WA License # MA00025104
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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