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Individual

NICHOLAS JOHN WILLIAM HEINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SUDPT

Contact information

Practice address
4841 AUTO CENTER WAY STE 101, BREMERTON, WA 98312-4388
(360) 373-1529
Mailing address
4841 AUTO CENTER WAY STE 101, BREMERTON, WA 98312-4388
(360) 373-1529

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60822088
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
91-1385373
WA
Enumeration date
08/10/2022
Last updated
08/10/2022
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