Provider Demographics
NPI:1326078411
Name:HEIN, URSULA-GRAYCE (ARNP)
Entity Type:Individual
Prefix:
First Name:URSULA-GRAYCE
Middle Name:
Last Name:HEIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:URSULA-GRAYCE
Other - Middle Name:
Other - Last Name:HEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-5096
Mailing Address - Country:US
Mailing Address - Phone:360-738-2200
Mailing Address - Fax:360-752-5682
Practice Address - Street 1:4545 CORDATA PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7123
Practice Address - Country:US
Practice Address - Phone:360-738-2200
Practice Address - Fax:360-752-5682
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK437363LF0000X
WAAP60093663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0250694OtherL&I AND CRIME VICTIMS
AK437OtherLICENSE
WA9733393OtherAETNA
WAH006OtherTRI-WEST (TRICARE0
WA1326078411Medicaid
AKCL2696Medicaid
WA1029HEOtherREGENCE
WA1029HEOtherREGENCE
AK8EZ012Medicare ID - Type UnspecifiedFNP
AKS55305Medicare UPIN