Basic Information
| Provider Information | |||||||||
| NPI: | 1609465608 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | URQUHART | ||||||||
| FirstName: | HEIDI | ||||||||
| MiddleName: | LYNN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22532 6TH AVE S APT B3 | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981986844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064842653 | ||||||||
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| Practice Location | |||||||||
| Address1: | 117 SW 160TH ST | ||||||||
| Address2: | |||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062422030 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2021 | ||||||||
| LastUpdateDate: | 01/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | RN00166311 | WA | Y | Nursing Service Providers | Registered Nurse | General Practice |
No ID Information.