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General NPI Number Information
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NPI Number | 1043301930
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Entity Type | Individual
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Provider Name | KARI CASE HEISTAND M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 210 POLK ST STE 4A
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-6739
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Country | US
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Telephone | 360-385-9918
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Fax | 360-385-1496
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Provider Business Mailing Address
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Address Line | 96 TWINSVIEW CT
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City | PORT LUDLOW
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State | WA
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Zip | 98365-9219
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Country | US
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Telephone | 360-621-9475
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD00045509
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License Number State | WA
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