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General NPI Number Information
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NPI Number | 1538605035
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Entity Type | Organization
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Legal Business Name | SUSAN C HECKER MD, PLLC
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 9631 N NEVADA ST SUITE 300
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City | SPOKANE
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State | WA
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Zip | 99218-1133
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Country | US
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Telephone | 509-489-4040
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Fax | 509-489-9190
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Provider Business Mailing Address
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Address Line | 6912 W MELVILLE RD
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City | CHENEY
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State | WA
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Zip | 99004-9027
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Country | US
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Telephone | 208-699-9870
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN CARNINE HECKER
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Credential | MD
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Telephone | 208-699-9870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD60237462
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License Number State | WA
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