Provider Demographics
NPI:1891805040
Name:WEST, HEATHER D (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:D
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7380 W 52ND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-3716
Mailing Address - Country:US
Mailing Address - Phone:303-463-5941
Mailing Address - Fax:
Practice Address - Street 1:9720 GRANT ST # 2
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2154
Practice Address - Country:US
Practice Address - Phone:303-756-3499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60479838207Q00000X
CAA64937207Q00000X
CO0062449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH00383Medicare UPIN
CA00A649371Medicare ID - Type UnspecifiedPPIN