Provider Demographics
NPI:1174809578
Name:HEYER, NANCY M (RPH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:HEYER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4706 42ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4500
Mailing Address - Country:US
Mailing Address - Phone:206-932-8045
Mailing Address - Fax:206-932-3094
Practice Address - Street 1:4706 42ND AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4500
Practice Address - Country:US
Practice Address - Phone:206-932-8045
Practice Address - Fax:206-932-3094
Is Sole Proprietor?:No
Enumeration Date:2011-10-30
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00017336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist