Individual
HEIDI J WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1625 19TH AVE, SEATTLE, WA 98122-2848
(206) 323-5770
Mailing address
1625 19TH AVE, SEATTLE, WA 98122-2848
(206) 323-5770
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00004198
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210297
LABOR AND INDUSTRIES
WA
01
—
1207WA
REGENCE RIDER BELLINGHAM
WA
01
—
4109WA
REGENCE RIDER SEATTLE
WA
05
—
8454449
—
WA
Enumeration date
03/17/2006
Last updated
07/09/2007
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