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Individual

HEATHER ROMA KROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
415 1ST AVE N, SUITE 200, SEATTLE, WA 98109-4744
(206) 859-5030
(206) 859-5031
Mailing address
415 1ST AVE N, SUITE 200, SEATTLE, WA 98109-4744
(206) 859-5030
(206) 859-5031

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD00036552
WA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MD00036552
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4300KR
REGENCE BLUE SHIELD
WA
01
7919156
AETNA
WA
Enumeration date
09/14/2006
Last updated
11/15/2012
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