Healthcare Provider Details

I. General information

NPI: 1003329566
Provider Name (Legal Business Name): HAYLEY MEEK HEESEMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S PIONEER WAY STE 150
MOSES LAKE WA
98837-4620
US

IV. Provider business mailing address

1616 S PIONEER WAY
MOSES LAKE WA
98837-2487
US

V. Phone/Fax

Practice location:
  • Phone: 509-793-9780
  • Fax: 509-764-3260
Mailing address:
  • Phone: 509-793-9715
  • Fax: 509-764-3244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD61049309
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: