Individual
CARLTON E HEINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 428-2166
(360) 428-2457
Mailing address
505 S 336TH STREET, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00046107
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0227813
LIWA
WA
01
—
7196HE
BSWA
—
05
—
8463499
—
WA
Enumeration date
06/27/2006
Last updated
05/23/2008
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