Provider Demographics
NPI:1669776381
Name:SHEFFELS, HEIDI LAURIE (LMP)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:LAURIE
Last Name:SHEFFELS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3403 STEAMBOAT ISLAND RD NW
Mailing Address - Street 2:PMB #497
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-9322
Mailing Address - Country:US
Mailing Address - Phone:360-866-6479
Mailing Address - Fax:360-357-6930
Practice Address - Street 1:6541 SEXTON DR NW
Practice Address - Street 2:SUITE A
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-866-6479
Practice Address - Fax:360-866-1461
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004885174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist