Provider Demographics
NPI:1730145376
Name:MACNEIL, HEATHER NOEL (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NOEL
Last Name:MACNEIL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 HARVESTER LOOP
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-9015
Mailing Address - Country:US
Mailing Address - Phone:509-886-1575
Mailing Address - Fax:
Practice Address - Street 1:2440 HARVESTER LOOP
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-9015
Practice Address - Country:US
Practice Address - Phone:509-886-8033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002295174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7683253Medicaid