Provider Demographics
NPI:1942529839
Name:MILLS, HEIDI MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:MILLS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MARIE
Other - Last Name:KESSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:900 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4168
Mailing Address - Country:US
Mailing Address - Phone:425-258-7311
Mailing Address - Fax:425-258-7618
Practice Address - Street 1:900 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4168
Practice Address - Country:US
Practice Address - Phone:425-258-7311
Practice Address - Fax:425-258-7618
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60132815225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist