Individual
MR. KEN S. HEILBRUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
545 ANDOVER PARK W, # 109, TUKWILA, WA 98188
(206) 467-1949
(206) 467-1912
Mailing address
545 ANDOVER PARK W, # 109, TUKWILA, WA 98188
(206) 467-1949
(206) 467-1912
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD00013791
WA
2085R0202X
Diagnostic Radiology Physician
Primary
MD00013791
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1055670
—
WA
05
—
10556760
—
WA
Enumeration date
05/17/2006
Last updated
07/08/2011
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