Healthcare Provider Details
I. General information
NPI: 1477642049
Provider Name (Legal Business Name): HEIDI K LUCAS N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
122 16TH AVE E 2ND FLR
SEATTLE WA
98112-5212
US
IV. Provider business mailing address
1548 NW 62ND ST
SEATTLE WA
98107-2335
US
V. Phone/Fax
- Phone: 206-292-2277
- Fax: 206-292-2015
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: