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Individual

ENOCH HEILESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
313 S 9TH AVE, YAKIMA, WA 98902-3516
(509) 248-8040
(509) 248-8709
Mailing address
313 S 9TH AVE, YAKIMA, WA 98902-3516
(509) 248-8040
(509) 248-8709

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI60739280
WA
224P00000X
Prosthetist
Primary
PS60756338
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120244
LABOR & INDUSTRIES
05
9045675
WA
Enumeration date
05/18/2017
Last updated
07/21/2022
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