Provider Demographics
NPI:1063562114
Name:STANGER, BILLIE LEE (BA, LMP)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:LEE
Last Name:STANGER
Suffix:
Gender:F
Credentials:BA, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 VALLEY MALL PKWY
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4831
Mailing Address - Country:US
Mailing Address - Phone:509-884-4344
Mailing Address - Fax:
Practice Address - Street 1:1610 GRANT RD
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5271
Practice Address - Country:US
Practice Address - Phone:509-886-8592
Practice Address - Fax:509-886-3612
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004204225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0039482OtherLABOR & INDUSTRIES