Provider Demographics
NPI:1356846794
Name:SITTON, HEIDI COLETTE (RN)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:COLETTE
Last Name:SITTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13515 259TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-9698
Mailing Address - Country:US
Mailing Address - Phone:425-830-6030
Mailing Address - Fax:
Practice Address - Street 1:13515 259TH AVE SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-9698
Practice Address - Country:US
Practice Address - Phone:425-830-6030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00068527163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA$$$$$$$$$Medicaid