Provider Demographics
NPI:1265903413
Name:HELLER, JEANNE ELIZABETH (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:ELIZABETH
Last Name:HELLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:JEANNE
Other - Middle Name:ELIZABETH
Other - Last Name:HORVATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3200 SHYLEEN ST
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1261
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 SHYLEEN ST
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1261
Practice Address - Country:US
Practice Address - Phone:314-602-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist