Provider Demographics
NPI:1790183317
Name:HEALING HEART CLINIC
Entity Type:Organization
Organization Name:HEALING HEART CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DUARTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-285-9020
Mailing Address - Street 1:1313 MARKET ST STE 3000
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5457
Mailing Address - Country:US
Mailing Address - Phone:425-285-9020
Mailing Address - Fax:
Practice Address - Street 1:1313 MARKET ST STE 3000
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5457
Practice Address - Country:US
Practice Address - Phone:425-285-9020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization