Provider Demographics
NPI:1013720622
Name:FARNER, HEATHER DIANE
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DIANE
Last Name:FARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 NW MISTY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9430
Mailing Address - Country:US
Mailing Address - Phone:360-434-5090
Mailing Address - Fax:
Practice Address - Street 1:2059 NW MISTY RIDGE LN
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9430
Practice Address - Country:US
Practice Address - Phone:360-434-5090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician