Individual
CAROL ANN HEIDEGGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
39402 NE 109TH AVE, LA CENTER, WA 98629-4826
(360) 263-1604
Mailing address
39402 NE 109TH AVE, LA CENTER, WA 98629-4826
(360) 263-1604
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00123032
WA
Other
Enumeration date
01/31/2014
Last updated
01/31/2014
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