Provider Demographics
NPI:1194483149
Name:MURPHY, HEATHER ELISE (PHD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ELISE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ELISE
Other - Last Name:MURPHY SECRIST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16731 8TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-5013
Mailing Address - Country:US
Mailing Address - Phone:206-769-3850
Mailing Address - Fax:
Practice Address - Street 1:1622 NE 179TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-3965
Practice Address - Country:US
Practice Address - Phone:206-769-3850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60160378103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist