Provider Demographics
NPI:1548433717
Name:ROBERTS, HEIDI LEE (DPT)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:LEE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:253 RHINE VILLAGE DRIVE
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672
Mailing Address - Country:US
Mailing Address - Phone:509-493-5119
Mailing Address - Fax:509-493-2435
Practice Address - Street 1:253 RHINE VILLAGE DRIVE
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672
Practice Address - Country:US
Practice Address - Phone:509-493-5119
Practice Address - Fax:509-493-2435
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist