Provider Demographics
NPI:1619511821
Name:HEATHER L SIEGEL, LIMITED
Entity Type:Organization
Organization Name:HEATHER L SIEGEL, LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:253-905-5537
Mailing Address - Street 1:PO BOX 17866
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98127-1864
Mailing Address - Country:US
Mailing Address - Phone:206-795-0697
Mailing Address - Fax:
Practice Address - Street 1:19803 N CREEK PKWY STE 205
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-5014
Practice Address - Country:US
Practice Address - Phone:253-905-5537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty