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General NPI Number Information
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NPI Number | 1770476517
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Entity Type | Individual
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Provider Name | HEIDI MIRANDA ORMBREK LMHCA
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Gender | Female
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1320 ALAMEDA AVE
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City | FIRCREST
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State | WA
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Zip | 98466-6500
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Country | US
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Telephone | 360-360-0334
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Fax |
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Provider Business Mailing Address
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Address Line | 901 N M ST APT 6
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City | TACOMA
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State | WA
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Zip | 98403-1503
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Country | US
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Telephone | 360-739-6738
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC61444115
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License Number State | WA
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