Provider Demographics
NPI:1760440945
Name:MCWILLIAMS, HEATHER LYNNE (MS PT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNNE
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:225 NW LINDVIG WAY STE 6
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-9090
Mailing Address - Country:US
Mailing Address - Phone:360-990-6627
Mailing Address - Fax:866-590-7449
Practice Address - Street 1:10432 NE BRACKENWOOD LN
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1123
Practice Address - Country:US
Practice Address - Phone:360-990-6627
Practice Address - Fax:866-590-7449
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPT00009235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8423741Medicaid
WA8423741Medicaid