Individual
CHRISTOPHER P HEISTAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
4510 INTELCO LOOP SE, STE. B, LACEY, WA 98503-6004
(360) 786-1753
(360) 786-1793
Mailing address
1401 MARVIN RD NE, 307 #266, LACEY, WA 98516-5749
(360) 786-1753
(360) 786-1793
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5319HE
REGENCE BLUE SHIELD
WA
05
—
7125396
—
WA
Enumeration date
11/11/2005
Last updated
08/26/2014
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