Provider Demographics
NPI:1114196466
Name:HELLER, ALLAN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:CHRISTOPHER
Last Name:HELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:509-838-2531
Mailing Address - Fax:509-755-6580
Practice Address - Street 1:801 W 5TH AVE
Practice Address - Street 2:SUITE #525
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2823
Practice Address - Country:US
Practice Address - Phone:509-838-2531
Practice Address - Fax:509-755-6580
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81041207T00000X
WAMD60218165207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2013414Medicaid