Healthcare Provider Details

I. General information

NPI: 1184792459
Provider Name (Legal Business Name): LORI ANN HEINER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 W BOONE AVE
SPOKANE WA
99201-2354
US

IV. Provider business mailing address

1013 N PIERCE RD
SPOKANE VALLEY WA
99206-5022
US

V. Phone/Fax

Practice location:
  • Phone: 509-323-7324
  • Fax:
Mailing address:
  • Phone: 509-924-2168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN00103513
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: