Provider Demographics
NPI:1265767487
Name:DAY, HEATHER ANN (APNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:DAY
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:A
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:5700 100TH ST SW STE 510
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2767
Mailing Address - Country:US
Mailing Address - Phone:253-459-6060
Mailing Address - Fax:
Practice Address - Street 1:5700 100TH ST SW STE 510
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2767
Practice Address - Country:US
Practice Address - Phone:253-459-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3863-33363LF0000X
WAAP60466571363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI07028Medicare PIN