Healthcare Provider Details

I. General information

NPI: 1679514475
Provider Name (Legal Business Name): HEIDI ANN HOFFMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 SE 36TH ST SUITE 210
BELLEVUE WA
98006-1657
US

IV. Provider business mailing address

14100 SE 36TH ST SUITE 210
BELLEVUE WA
98006-1657
US

V. Phone/Fax

Practice location:
  • Phone: 425-653-7100
  • Fax: 425-653-7109
Mailing address:
  • Phone: 425-653-7100
  • Fax: 425-653-7109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00008053
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: