Provider Demographics
NPI:1073238101
Name:HEIDI TAFJORD, ARNP, PLLC
Entity Type:Organization
Organization Name:HEIDI TAFJORD, ARNP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER, OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:TAFJORD
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, PMHNP
Authorized Official - Phone:206-495-5393
Mailing Address - Street 1:3409 NW 70TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-6134
Mailing Address - Country:US
Mailing Address - Phone:206-495-5393
Mailing Address - Fax:206-535-6876
Practice Address - Street 1:3409 NW 70TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-6134
Practice Address - Country:US
Practice Address - Phone:206-495-5393
Practice Address - Fax:206-535-6876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1427104405OtherPRIVATE INSURANCE