Provider Demographics
NPI:1528220159
Name:READHEAD, HEATHER TINDALL (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:TINDALL
Last Name:READHEAD
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:CA
Other - Last Name:TINDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD MPH
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:509-474-2072
Mailing Address - Fax:
Practice Address - Street 1:1212 N PINES RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4939
Practice Address - Country:US
Practice Address - Phone:509-893-8140
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254167207Q00000X
CAA116217207Q00000X
WAMD60535689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine