Individual
MARCUS WILLIAM HEISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
610 E. MAIN STREET, ELMA, WA 98541
(360) 346-2222
Mailing address
820 TAYLOR LN NE UNIT A, LACEY, WA 98506-5289
(916) 716-4550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A139570
CA
207Q00000X
Family Medicine Physician
MD60849399
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A139570
MEDICAL LICENSE
CA
01
—
MD60849399
WASHINGTON STATE
WA
Enumeration date
04/21/2014
Last updated
08/02/2022
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