Provider Demographics
NPI:1336577881
Name:HEALTHY IN HEALTHCARE
Entity type:Organization
Organization Name:HEALTHY IN HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUMMERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-601-6844
Mailing Address - Street 1:1805 SE MANOR AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-6457
Mailing Address - Country:US
Mailing Address - Phone:360-601-6844
Mailing Address - Fax:
Practice Address - Street 1:11818 SE MILL PLAIN BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5089
Practice Address - Country:US
Practice Address - Phone:360-601-6844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60409273225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty