Provider Demographics
NPI:1275935751
Name:HARBY, HEATHER CHERI (PA)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:CHERI
Last Name:HARBY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:341 W PINE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4119
Mailing Address - Country:US
Mailing Address - Phone:406-327-0269
Mailing Address - Fax:406-327-0264
Practice Address - Street 1:4311 11TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-6366
Practice Address - Country:US
Practice Address - Phone:206-616-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-44376363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical