Provider Demographics
NPI:1447421581
Name:SLOAN, HEATHER JO (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:JO
Last Name:SLOAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 5TH AVE SE
Mailing Address - Street 2:#202
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1505
Mailing Address - Country:US
Mailing Address - Phone:360-956-3900
Mailing Address - Fax:360-956-3903
Practice Address - Street 1:911 5TH AVE SE
Practice Address - Street 2:#202
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1505
Practice Address - Country:US
Practice Address - Phone:360-956-3900
Practice Address - Fax:360-956-3903
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAV99251OtherUPIN
WAG8802570Medicare PIN