Provider Demographics
NPI:1134225774
Name:FLUEGGE, HEIDI RUTH (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:RUTH
Last Name:FLUEGGE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 WESTMORLAND DR
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-1237
Mailing Address - Country:US
Mailing Address - Phone:509-663-1242
Mailing Address - Fax:509-663-1242
Practice Address - Street 1:1009 WESTMORLAND DR
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-1237
Practice Address - Country:US
Practice Address - Phone:509-663-1242
Practice Address - Fax:509-663-1242
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003336174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7683550Medicaid