Provider Demographics
NPI:1437225570
Name:HEATHER MUEHLER OD PS
Entity Type:Organization
Organization Name:HEATHER MUEHLER OD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:360-888-3260
Mailing Address - Street 1:1350 MARVIN RD NE STE D
Mailing Address - Street 2:PEARLE VISION
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-3877
Mailing Address - Country:US
Mailing Address - Phone:360-491-5090
Mailing Address - Fax:
Practice Address - Street 1:1350 MARVIN RD NE STE D
Practice Address - Street 2:PEARLE VISION
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-3877
Practice Address - Country:US
Practice Address - Phone:360-491-5090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003832152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U85035Medicare UPIN