Provider Demographics
NPI:1689051831
Name:TONDER, HEATHER B
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:B
Last Name:TONDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 HAYTON ST
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-5427
Mailing Address - Country:US
Mailing Address - Phone:360-440-7758
Mailing Address - Fax:
Practice Address - Street 1:1230 BAY ST
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-5214
Practice Address - Country:US
Practice Address - Phone:253-851-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASLPI.SI.60521580235Z00000X
WAESA 491183J235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist