Provider Demographics
NPI:1013588128
Name:RUNIONS, HEAVEN LEIGH
Entity Type:Individual
Prefix:
First Name:HEAVEN
Middle Name:LEIGH
Last Name:RUNIONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 CASASSA RD
Mailing Address - Street 2:
Mailing Address - City:CLE ELUM
Mailing Address - State:WA
Mailing Address - Zip Code:98922-7700
Mailing Address - Country:US
Mailing Address - Phone:509-929-3035
Mailing Address - Fax:
Practice Address - Street 1:1810 CASASSA RD
Practice Address - Street 2:
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-7700
Practice Address - Country:US
Practice Address - Phone:509-929-3035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion