Provider Demographics
NPI:1164285102
Name:HEIMBIGNER, RENEE LESLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LESLEY
Last Name:HEIMBIGNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:LESLEY
Other - Last Name:SCHAEFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:945 SW ITANI DR
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-2064
Mailing Address - Country:US
Mailing Address - Phone:509-432-1728
Mailing Address - Fax:
Practice Address - Street 1:835 SE BISHOP BLVD
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5512
Practice Address - Country:US
Practice Address - Phone:509-432-1728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP10667183500000X
WAPH00065185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist