MEDICARE: DR. BERNICE RUTH HECKER MD

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	207L00000X	Anesthesiology Physician	MD 00015494	WA

General Provider Information

NPI Number	:	1699115725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERNICE RUTH HECKER MD

Provider Business Mailing Address
First Line	:	1127 FEDERAL AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4314
Country	:	US
Telephone Number	:	206-328-4093
Fax Number	:

Provider Business Practice Location Address
First Line	:	1127 FEDERAL AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4314
Country	:	US
Telephone Number	:	206-328-4093
Fax Number	:

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

Provider Enumeration Date	:	07/03/2013
Last Update Date	:	07/03/2013

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