Provider Demographics
NPI:1245401975
Name:HAMPTON, HEATHER (HYGIENIST)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:HYGIENIST
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:KISLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:605 S. COOLIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837
Mailing Address - Country:US
Mailing Address - Phone:509-765-0674
Mailing Address - Fax:509-764-0344
Practice Address - Street 1:605 S. COOLIDGE STREET
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837
Practice Address - Country:US
Practice Address - Phone:509-765-0674
Practice Address - Fax:509-764-0344
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH0007643124Q00000X
WA124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist