Provider Demographics
NPI:1063832525
Name:KNIFFEN, HEATHER (MSW/LICSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:KNIFFEN
Suffix:
Gender:F
Credentials:MSW/LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 GEHR ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-8004
Mailing Address - Country:US
Mailing Address - Phone:509-679-5244
Mailing Address - Fax:509-275-7916
Practice Address - Street 1:810 GEHR ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-8004
Practice Address - Country:US
Practice Address - Phone:509-679-5244
Practice Address - Fax:509-275-7916
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW0007624104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker