Provider Demographics
NPI:1750924197
Name:BRUNS, HEATHER (APRN-CNM)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BRUNS
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16850 SE 272ND ST STE 210
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4931
Mailing Address - Country:US
Mailing Address - Phone:425-690-3480
Mailing Address - Fax:425-690-9480
Practice Address - Street 1:16850 SE 272ND ST STE 210
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4931
Practice Address - Country:US
Practice Address - Phone:425-690-9480
Practice Address - Fax:425-690-9480
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.019411367A00000X
WAAP61229295367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty