Provider Demographics
NPI:1831728625
Name:BARNES, HEATHER LEANNE (MC60476798)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LEANNE
Last Name:BARNES
Suffix:
Gender:F
Credentials:MC60476798
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 82ND PL NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-3534
Mailing Address - Country:US
Mailing Address - Phone:206-779-3386
Mailing Address - Fax:
Practice Address - Street 1:1622 3RD ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-5004
Practice Address - Country:US
Practice Address - Phone:406-426-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60476798101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health