Healthcare Provider Details

I. General information

NPI: 1366773434
Provider Name (Legal Business Name): ESTHER RAE HEATH-MILLS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 5TH ST SE STE 3600
PUYALLUP WA
98372-4665
US

IV. Provider business mailing address

P.O. BOX 5299 MS:1313-5-PCO
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 253-697-3480
  • Fax: 253-697-3490
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60127006
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: