Healthcare Provider Details

I. General information

NPI: 1447599493
Provider Name (Legal Business Name): HEATHER HYDZIK N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2013
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 116TH AVE NE STE 100
BELLEVUE WA
98004-3800
US

IV. Provider business mailing address

1260 116TH AVE NE STE 100
BELLEVUE WA
98004-3800
US

V. Phone/Fax

Practice location:
  • Phone: 425-957-0761
  • Fax: 425-957-1156
Mailing address:
  • Phone: 425-957-0761
  • Fax: 425-957-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60452686
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: