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Organization

CHRISTOPHER HEISTAND SLP, INC. PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRISTOPHER P HEISTAND SLP (OWNER)
(360) 786-1753
Entity
Organization

Contact information

Practice address
4531 INTELCO LOOP SE, SUITE 3, LACEY, WA 98503-5941
(360) 786-1753
(360) 786-1793
Mailing address
4820 YELM HWY SE STE B, PMB 210, LACEY, WA 98503-4904
(360) 786-1753
(360) 786-1793

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003377
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7125396
WA
Enumeration date
03/10/2008
Last updated
03/10/2008
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