Individual
THEODORE D HEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
307 S 13TH ST STE 300, MOUNT VERNON, WA 98274-4109
(360) 336-9757
(360) 336-2088
Mailing address
307 S 13TH ST STE 300, MOUNT VERNON, WA 98274-4109
(360) 336-9757
(360) 336-2088
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00014826
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8397804
—
WA
Enumeration date
06/11/2006
Last updated
08/03/2009
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