MEDICARE: SHERRI A HEISE PHARM.D., CACP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH00012023	WA

General Provider Information

NPI Number	:	1386625176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRI A HEISE PHARM.D., CACP

Provider Business Mailing Address
First Line	:	9011 RIDGEVIEW CIR W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-1334
Country	:	US
Telephone Number	:	253-565-5139
Fax Number	:

Provider Business Practice Location Address
First Line	:	4545 POINT FOSDICK DR NW
Second Line	:	SUITE #250
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-1700
Country	:	US
Telephone Number	:	253-530-8090
Fax Number	:	253-530-8081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	06/05/2012

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