Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2021-00452 | NC |
Y | 208600000X | Surgeon | 2021-00452 | NC |
N | 208200000X | Surgeon | 51412 | CO |
N | 208600000X | Surgeon | 51412 | CO |
N | 208200000X | Surgeon | MD60514747 | WA |
N | 208600000X | Surgeon | MD60514747 | WA |
NPI | 1003016163 |
---|---|
Provider Name | Heather Anne Hartshorn |
First Address | Spokane, WA 99220-3649 |
Second Address | Spokane Valley, WA 99216-1097 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
82723036 | (05) | CO |