Provider Demographics
NPI:1316166234
Name:HESCH, KIM (LMT)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HESCH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17430 AMBAUM BLVD S APT 49
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1780
Mailing Address - Country:US
Mailing Address - Phone:206-439-9556
Mailing Address - Fax:206-244-2613
Practice Address - Street 1:2120 SW 152ND ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2027
Practice Address - Country:US
Practice Address - Phone:206-244-7973
Practice Address - Fax:206-244-2613
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017323225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0184808OtherWORKDER'S COMP