Provider Demographics
NPI:1871078808
Name:D'ERILEEN, HEATHER ELIZABETH (DNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:D'ERILEEN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ELIZABETH
Other - Last Name:CHAMBERLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:MERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97532-0081
Mailing Address - Country:US
Mailing Address - Phone:425-381-3685
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 81
Practice Address - Street 2:
Practice Address - City:MERLIN
Practice Address - State:OR
Practice Address - Zip Code:97532-0081
Practice Address - Country:US
Practice Address - Phone:425-381-3685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60475412163W00000X
WAAP60903132363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1871078808Medicaid