Individual
DALE D HEASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1321 AARON DR, RICHLAND, WA 99352-4678
(509) 943-3171
(509) 946-0905
Mailing address
1321 AARON DR, PO BOX 610, RICHLAND, WA 99352-4678
(509) 943-3171
(509) 946-0905
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1129
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0144211
WA LABOR & INDUSTRY
WA
01
—
11102
GROUP HEALTH
—
01
—
4100016629
RAILROAD MEDICARE
—
01
—
HE6761
BLUE CROSS BLUE SHIELD
—
Enumeration date
08/28/2006
Last updated
03/07/2023
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