Healthcare Provider Details

I. General information

NPI: 1255861878
Provider Name (Legal Business Name): EMILY DAUNER CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY HEITZMAN CPNP

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 12/03/2024
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 140TH AVE. NE BUILDING C
BELLEVUE WA
98005
US

IV. Provider business mailing address

2475 140TH AVE. NE BUILDING C
BELLEVUE WA
98005
US

V. Phone/Fax

Practice location:
  • Phone: 425-828-2257
  • Fax: 425-636-8139
Mailing address:
  • Phone: 513-227-5103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAP60749066
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAP60749066
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP60749066
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: