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General NPI Number Information
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NPI Number | 1427136977
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Entity Type | Organization
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Legal Business Name | HERITAGE FAMILY MEDICINE
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 4001 HARRISON AVE NW STE 101
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City | OLYMPIA
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State | WA
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Zip | 98502-5084
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Country | US
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Telephone | 360-704-2362
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Fax | 360-350-1445
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Provider Business Mailing Address
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Address Line | 4001 HARRISON AVE NW
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City | OLYMPIA
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State | WA
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Zip | 98502-5084
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Country | US
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Telephone | 360-704-2362
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Fax | 360-350-1445
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Authorized Official
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Title or Position | OWNER
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Name | AMANDEEP KAUR MANN
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Credential | DNP
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Telephone | 253-394-6574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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