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NPI Code Detail

MEDICARE: SARA ELIZABETH HEIBERG CPO

MEDICARE: SARA ELIZABETH HEIBERG CPO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Z00000XOrthotist
2224P00000XProsthetist

General Provider Information

NPI Number : 1154553204
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA ELIZABETH HEIBERG CPO
Provider Business Mailing Address
First Line : 723 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4139
Country : US
Telephone Number : 253-383-4447
Fax Number :
Provider Business Practice Location Address
First Line : 723 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4139
Country : US
Telephone Number : 253-383-4447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2009
Last Update Date : 04/22/2014

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Directions to “ SARA ELIZABETH HEIBERG CPO” Practice Location

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