Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | OP60469079 | WA |
NPI | 1376772616 |
---|---|
Provider Name | Dr. Natashia Monique Madrid Heimburger |
First Address | Vancouver, WA 98686-2309 |
Second Address | Vancouver, WA 98664-1965 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2009 |
Last Update Date | 22/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1376772616 | (05) | WA |