Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD60351094 | WA |
NPI | 1003131137 |
---|---|
Provider Name | Heather Marie Henne |
First Address | Renton, WA 98057-2908 |
Second Address | Renton, WA 98057-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2010 |
Last Update Date | 08/07/2013 |