Individual
DR. KAREN MARIE HEASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD4077
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0228350
WA LABOR AND INDUSTRY
WA
01
—
8868183
PTAN
WA
Enumeration date
01/02/2007
Last updated
02/04/2008
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