Aryonna Bella Waters, LMP / LMT

Individual provider Active NPI Community Health Worker · Stevenson, WA

NPI 1235259383 · NPPES record last updated Apr 19, 2017

Key facts

NPI
1235259383
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
License
15880 (OR)
Practice address
100 NW 2ND St
Stevenson, WA 98648-4225
Phone
(509) 427-7797
Fax
(509) 427-7797
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15880ORMDCommunity Health Worker
MA00023703WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 15880 OR Yes
Massage Therapist 225700000X MA00023703 WA

Addresses

Primary practice location

100 NW 2ND St
Stevenson, WA 98648-4225

Mailing address

PO Box 591
Carson, WA 98610-0591
Phone (509) 427-7797

Other providers in Stevenson, WA

All providers in Stevenson, WA · Community Health Worker in Washington

Sources for this page

Verify at the official NPI Registry.