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Individual
MRS. TIFFANY ELISE HEESE
Active
Individual
MRS. TIFFANY ELISE HEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12294
TX
363A00000X
Physician Assistant
PA60637513
WA
363AM0700X
Medical Physician Assistant
PA60637513
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2061724
—
WA
01
—
G001045700
GROUP PTAN(P)
WA
Enumeration date
01/18/2016
Last updated
01/17/2019
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