Individual
HEIDI M HERMES SHANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
565 EUREKA WAY, SEQUIM, WA 98382-5074
(360) 582-0808
(253) 984-2049
Mailing address
565 EUREKA WAY, SEQUIM, WA 98382-5074
(360) 582-0808
(253) 984-2049
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD.6047903
WA
207N00000X
Dermatology Physician
MD60479603
WA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD.6047903
WA
207NS0135X
Procedural Dermatology Physician
MD.6047903
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2038330
—
WA
Enumeration date
07/04/2009
Last updated
07/11/2023
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