Individual
FRED E. HEIDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 16TH AVE E, CSB-4, SEATTLE, WA 98112-5211
(206) 326-3530
Mailing address
PO BOX 34581, SEATTLE, WA 98124-1581
(509) 241-7349
(509) 241-7628
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00016024
WA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MD00016024
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233042
L&I
WA
05
—
8445900
—
WA
Enumeration date
01/05/2007
Last updated
08/07/2009
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