Heinzelman, Keith Ronald
Heinzelman, Keith Ronald is an individual health care provider with primary practice located at 563 Madison Ave N , Bainbridge Island WA 98110-1768. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Heinzelman, Keith Ronald can be contacted via phone (206) 855-8455.Contact Information
Primary practice address
563 Madison Ave N
Bainbridge Island WA 98110-1768
Phone: (206) 855-8455
Fax: (206) 855-8465
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand | 2251H1200X | Washington | |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT00008747 | Washington |
Profile Details
| NPI number | 1194826479 |
|---|---|
| LBN Legal business name | Heinzelman, Keith Ronald |
| Credentials | DPT, CHT, MTC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Dec 28th, 2020 - about 5 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 | 1194826479 | NPPES |
| Washington | MEDICAID | 8450744 |
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