Healthcare Provider Details

I. General information

NPI: 1528154341
Provider Name (Legal Business Name): HEIKE GURTH HORNSBY LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIKE DOYLE LM, CPM

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13128 TOTEM LAKE BLVD NE SUITE 101
KIRKLAND WA
98034
US

IV. Provider business mailing address

13128 TOTEM LAKE BLVD NE SUITE 101
KIRKLAND WA
98034
US

V. Phone/Fax

Practice location:
  • Phone: 425-823-1919
  • Fax: 425-823-7037
Mailing address:
  • Phone: 425-823-1919
  • Fax: 425-823-7037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW00000158
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: