Healthcare Provider Details

I. General information

NPI: 1740665009
Provider Name (Legal Business Name): CHELSEA BETH HEFFNER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA BETH ALLEN

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11511 NE 10TH ST
BELLEVUE WA
98004-8578
US

IV. Provider business mailing address

11511 NE 10TH ST
BELLEVUE WA
98004-8578
US

V. Phone/Fax

Practice location:
  • Phone: 425-502-3000
  • Fax: 425-502-3589
Mailing address:
  • Phone: 425-502-3000
  • Fax: 425-502-3589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA60578617
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: