Individual
DR. HEATHER DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14406 NE 20TH AVE, VANCOUVER, WA 98686-1448
(800) 813-2000
Mailing address
14406 NE 20TH AVE, VANCOUVER, WA 98686-1448
(800) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
60785502
WA
207Q00000X
Family Medicine Physician
MD60785502
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2014
Last updated
04/03/2018
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