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Individual

HEATHER N DAVIS-REMACLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
825 SE BISHOP BLVD, STE 200, PULLMAN, WA 99163-5517
(509) 332-2517
(509) 334-9247
Mailing address
825 SE BISHOP BLVD, STE 200, PULLMAN, WA 99163-5517
(509) 332-2517
(509) 334-9247

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-1132
ID
363A00000X
Physician Assistant
Primary
PA60427963
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2033528
PROVIDER ONE
WA
01
323971
L & I (NON NETWORK)
ID
01
P01341941
RR MEDICARE
ID
Enumeration date
10/25/2013
Last updated
06/22/2017
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