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General NPI Number Information
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NPI Number | 1083760110
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Entity Type | Individual
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Provider Name | HEATHER A WOLOSHYN DDS., MSD.
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1314 8TH ST NE SUITE 102
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City | AUBURN
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State | WA
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Zip | 98002-4587
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Country | US
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Telephone | 253-833-5455
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Fax | 253-939-5898
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Provider Business Mailing Address
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Address Line | 1314 8TH ST NE SUITE 102
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City | AUBURN
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State | WA
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Zip | 98002-4587
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Country | US
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Telephone | 253-833-5455
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Fax | 253-939-5898
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE00006303
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License Number State | WA
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