Provider Demographics
NPI:1942420658
Name:DOLLARHIDE, HEATHER L (LMP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:DOLLARHIDE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14700 NE 8TH ST STE 115
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4115
Mailing Address - Country:US
Mailing Address - Phone:425-644-8386
Mailing Address - Fax:425-644-2560
Practice Address - Street 1:14700 NE 8TH ST STE 115
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4115
Practice Address - Country:US
Practice Address - Phone:425-644-8386
Practice Address - Fax:425-644-2560
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017976174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA142129OtherLABOR AND INDUSTRIES
WA8942553OtherCRIME VICTIMS
WA8942551OtherCRIME VICTIMS
WA194305OtherLABOR AND INDUSTRIES