Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 208800000X | OR |
Y | 208800000X | Urologist | MD60368349 | WA |
NPI | 1043476898 |
---|---|
Provider Name | Ms. Adrienne Michelle Heckler |
First Address | Vancouver, WA 98664 |
Second Address | Vancouver, WA 98686 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2008 |
Last Update Date | 30/09/2013 |