Provider Demographics
NPI:1881202059
Name:HEILMAN, AUSTIN REID
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:REID
Last Name:HEILMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:REID
Other - Last Name:HEILMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:507 NE NORTHGATE WAY APT 239
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6190
Mailing Address - Country:US
Mailing Address - Phone:520-234-3843
Mailing Address - Fax:
Practice Address - Street 1:507 NE NORTHGATE WAY APT 239
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6190
Practice Address - Country:US
Practice Address - Phone:520-234-3843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician