Individual
MS. MARY CAROL HEITKEMPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3146 MOORE ST SE, TUMWATER, WA 98501-3517
(360) 791-5212
Mailing address
3146 MOORE ST SE, OLYMPIA, WA 98501
(360) 791-5212
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00082861
WA
Other
Enumeration date
06/01/2017
Last updated
07/21/2022
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