Ellis, Heidi
Ellis, Heidi is an individual health care provider with primary practice located at 1822 Black Lake Blvd Sw Ste 101 , Olympia WA 98512-5628. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Ellis, Heidi can be contacted via phone (360) 709-9909.Contact Information
Primary practice address
1822 Black Lake Blvd Sw Ste 101
Olympia WA 98512-5628
Phone: (360) 709-9909
Fax: (360) 709-9915
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | DH00004498 | Washington |
Profile Details
| NPI number | 1285853788 |
|---|---|
| LBN Legal business name | Ellis, Heidi |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 24th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285853788 | NPPES |
| Washington | MEDICAID | 5901871 |
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