Provider Demographics
NPI:1083760110
Name:WOLOSHYN, HEATHER A (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:A
Last Name:WOLOSHYN
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 8TH ST NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4587
Mailing Address - Country:US
Mailing Address - Phone:253-833-5455
Mailing Address - Fax:253-939-5898
Practice Address - Street 1:1314 8TH ST NE
Practice Address - Street 2:SUITE 102
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4587
Practice Address - Country:US
Practice Address - Phone:253-833-5455
Practice Address - Fax:253-939-5898
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000063031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics