Provider Demographics
NPI:1255977781
Name:HEIMLICH, MERIDEE ANN I (BHS)
Entity type:Individual
Prefix:
First Name:MERIDEE
Middle Name:ANN
Last Name:HEIMLICH
Suffix:I
Gender:F
Credentials:BHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6803 88TH ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-6441
Mailing Address - Country:US
Mailing Address - Phone:253-948-8272
Mailing Address - Fax:
Practice Address - Street 1:6803 88TH ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-6441
Practice Address - Country:US
Practice Address - Phone:253-948-8272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL60150551104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker