Provider Demographics
NPI:1902289903
Name:HUTCHINSON, HEATHER ALLISON (LMP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ALLISON
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:ALLISON
Other - Last Name:YARGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:607 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ZILLAH
Mailing Address - State:WA
Mailing Address - Zip Code:98953
Mailing Address - Country:US
Mailing Address - Phone:509-829-5757
Mailing Address - Fax:509-829-5051
Practice Address - Street 1:607 1ST AVE
Practice Address - Street 2:
Practice Address - City:ZILLAH
Practice Address - State:WA
Practice Address - Zip Code:98953
Practice Address - Country:US
Practice Address - Phone:509-829-5757
Practice Address - Fax:509-829-5051
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018243225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist