Healthcare Provider Details

I. General information

NPI: 1174809578
Provider Name (Legal Business Name): NANCY M HEYER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2011
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4706 42ND AVE SW
SEATTLE WA
98116-4500
US

IV. Provider business mailing address

4706 42ND AVE SW
SEATTLE WA
98116-4500
US

V. Phone/Fax

Practice location:
  • Phone: 206-932-8045
  • Fax: 206-932-3094
Mailing address:
  • Phone: 206-932-8045
  • Fax: 206-932-3094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH 00017336
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: