Provider Demographics
NPI:1821078627
Name:SAVAGE, HEATHER ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANN
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:A
Other - Last Name:STUCKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2075 BARKLEY BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-6696
Mailing Address - Country:US
Mailing Address - Phone:360-733-4008
Mailing Address - Fax:360-733-4064
Practice Address - Street 1:2075 BARKLEY BLVD
Practice Address - Street 2:STE 200
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6696
Practice Address - Country:US
Practice Address - Phone:360-733-4008
Practice Address - Fax:360-733-4064
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8360356Medicaid
P00122944OtherRAILROAD MEDICARE
WA0174438OtherLABOR & INDUSTRY
A017OtherTRICARE
WA0174438OtherLABOR & INDUSTRY
A017OtherTRICARE