Healthcare Provider Details

I. General information

NPI: 1902552144
Provider Name (Legal Business Name): SIENA HEUER SLP, CF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 02/25/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 GROVE ST
MARYSVILLE WA
98270-4135
US

IV. Provider business mailing address

PO BOX 1451
EVERETT WA
98206-1451
US

V. Phone/Fax

Practice location:
  • Phone: 360-965-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSI61162993
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: