Provider Demographics
NPI:1982659116
Name:WASHENBERGER, HEIDI ANNE (PT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANNE
Last Name:WASHENBERGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:ANNE
Other - Last Name:WENDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9419 COPPERTOP LOOP NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110
Mailing Address - Country:US
Mailing Address - Phone:206-842-2428
Mailing Address - Fax:206-842-2890
Practice Address - Street 1:9419 COPPERTOP LOOP NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110
Practice Address - Country:US
Practice Address - Phone:206-842-2428
Practice Address - Fax:206-842-2890
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8524WAOtherREGENCE BLUE SHIELD
WA135862OtherDEPT OF LABOR & INDUSTRIE
WA5128102OtherAETNA/LEXINGTON, KY
WA810588134-05OtherKPS HEALTH PLANS
WA810588134-05OtherKPS HEALTH PLANS