Individual
HEATHER FAIRFAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
9040 JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-0001
(253) 968-3983
Mailing address
9040 JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-0001
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
248827
NC
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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