Provider Demographics
NPI:1295151835
Name:DEVLIN, HEATHER JEAN (RDH)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JEAN
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 SPRINGLAND LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-6864
Mailing Address - Country:US
Mailing Address - Phone:360-319-9285
Mailing Address - Fax:
Practice Address - Street 1:1616 CORNWALL AVE
Practice Address - Street 2:STE 205
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4648
Practice Address - Country:US
Practice Address - Phone:360-676-6177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00006248124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist