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NPI 1831221100

NPI 1831221100 : HEATHER A DENNISTON DC : ISSAQUAH, WA

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General NPI Number Information
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    NPI Number           |    1831221100
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    Entity Type          |    Individual 
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    Provider Name        |    HEATHER A DENNISTON DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/12/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    5825 221ST PL SE SUITE 103
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    City                 |    ISSAQUAH
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    State                |    WA
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    Zip                  |    98027-8927
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    Country              |    US
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    Telephone            |    425-392-7334
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    Fax                  |    425-392-8009
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Provider Business Mailing Address
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    Address Line         |    5825 221ST PL SE SUITE 103
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    City                 |    ISSAQUAH
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    State                |    WA
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    Zip                  |    98027-8927
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    Country              |    US
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    Telephone            |    425-392-7334
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    Fax                  |    425-392-8009
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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        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    CH00003287
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    License Number State |    WA
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