Provider Demographics
NPI:1093037889
Name:KING, HEATHER MICHELLE (RD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MICHELLE
Last Name:KING
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3108
Mailing Address - Country:US
Mailing Address - Phone:360-921-2667
Mailing Address - Fax:
Practice Address - Street 1:1734 26TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3108
Practice Address - Country:US
Practice Address - Phone:360-921-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2021-07-26
Deactivation Date:2021-02-24
Deactivation Code:
Reactivation Date:2021-07-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered