Provider Demographics
NPI:1366773434
Name:HEATH-MILLS, ESTHER RAE (ARNP)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:RAE
Last Name:HEATH-MILLS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5299
Mailing Address - Street 2:MS:1313-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1450 5TH ST SE STE 3600
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4665
Practice Address - Country:US
Practice Address - Phone:253-697-3480
Practice Address - Fax:253-697-3490
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60127006363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8449985Medicaid
WA0207943OtherLABOR AND INDUSTRIES
WA8860386Medicare PIN